Individual
ANIE SOPHIA DEROLUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, FNP-BC
Contact information
Practice address
152 WOOD AVE, HYDE PARK, MA 02136-3857
(617) 953-6617
Mailing address
152 WOOD AVE, HYDE PARK, MA 02136-3857
(617) 953-6617
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN2348277
MA
363LF0000X
Family Nurse Practitioner
Primary
RN2348277
MA
Other
Enumeration date
11/11/2022
Last updated
11/20/2023
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