Individual
DERRICK TYLER KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
ERWIN RD, DURHAM, NC 27710-0001
(919) 684-3595
Mailing address
ERWIN RD, DURHAM, NC 27710-0001
(919) 684-3595
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
208558
NC
Other
Enumeration date
08/05/2010
Last updated
08/05/2010
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