Individual
DEREK LEONARD EBBESKOTTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
140 FOX RD STE 104, VAN WERT, OH 45891-2490
(419) 232-5291
Mailing address
PO BOX 7527, DUBLIN, OH 43017-0727
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN.CNP.0033549
OH
Other
Enumeration date
03/27/2023
Last updated
03/22/2024
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