Individual
DERRETH C ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
789 CENTRAL AVENUE, DOVER, NH 03820-2526
(603) 740-2697
Mailing address
5 ELIZABETH RD, SOUTH BERWICK, ME 03908-2174
(603) 740-2649
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
047079-23-05
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000849
—
NH
Enumeration date
05/26/2006
Last updated
07/09/2007
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