Individual
LYNN MARIE DERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
103 E MAIN ST, FRUITLAND, MD 21826-1604
(410) 831-3899
(443) 210-2786
Mailing address
103 E MAIN ST, FRUITLAND, MD 21826-1604
(410) 831-3899
(443) 210-2786
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
R042119
MD
Other
Enumeration date
10/01/2025
Last updated
10/01/2025
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