Individual
KIRSTEN P. DERR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
418
NM
152W00000X
Optometrist
Primary
OPT.0003642
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
881369
—
AZ
05
—
9000196852
—
CO
05
—
L3596
—
NM
01
—
NM02P497
BC BS OF NM
NM
01
—
P00151450
RRB MEDICARE RAILROAD
NM
Enumeration date
09/12/2005
Last updated
02/12/2026
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