Individual
MRS. BRENDA JEAN DEROO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
300 SIOUX VALLEY DR, CHEROKEE, IA 51012-1205
(712) 225-6441
(712) 225-3333
Mailing address
316 CENTENNIAL DR, CHEROKEE, IA 51012
(712) 225-2093
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
000731
IA
363LF0000X
Family Nurse Practitioner
Primary
A057101
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010652
—
IA
Enumeration date
01/24/2006
Last updated
07/18/2011
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