Individual
DERRINGER FENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
440 E TAMPA ST, SPRINGFIELD, MO 65806-1131
(417) 851-1551
(417) 865-3479
Mailing address
440 E TAMPA ST, SPRINGFIELD, MO 65806-1131
(417) 851-1551
(417) 865-3479
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2021020649
MO
Other
Enumeration date
06/08/2021
Last updated
06/08/2021
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