Individual
DERRICK DILLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
14540 PRAIRIE LAKES BLVD N STE 102, NOBLESVILLE, IN 46060-4370
(317) 770-9253
(317) 770-0134
Mailing address
PO BOX 843022, KANSAS CITY, MO 64184-3022
(317) 770-6900
(317) 770-6911
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71015705A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300096299
—
IN
Enumeration date
10/26/2021
Last updated
05/16/2025
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