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Individual

DEREK RUSSELL NYE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN, PHN

Contact information

Practice address
3851 ROSECRANS ST STE 716, SAN DIEGO, CA 92110-3115
(619) 972-2432
Mailing address
3317 RIVIERA DR, SAN DIEGO, CA 92109-6614
(619) 201-0881

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95206866
CA

Other

Enumeration date
12/29/2020
Last updated
12/29/2020
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