Individual
MRS. DARLENE CARYN DERECZYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP-BC
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 283-7740
(313) 916-8007
Mailing address
6415 CONNAUGHT CT, CANTON, MI 48187-5484
(313) 283-7740
(313) 916-8007
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
4704140969
MI
363LA2100X
Acute Care Nurse Practitioner
Primary
470410969
MI
Other
Enumeration date
05/28/2009
Last updated
03/18/2010
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