Individual
PENNY DERAPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
333 MAIN STREET, CANAAN, ME 04929
(207) 474-6990
(207) 474-8899
Mailing address
118 MOOSEHEAD TRL, SUITE 5, NEWPORT, ME 04953-4020
(207) 368-4213
(207) 355-3033
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R15754
ME
Other
Enumeration date
10/11/2006
Last updated
07/08/2007
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