Individual
JENNIFER DERHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1952 NEW CREEK HWY, KEYSER, WV 26726-7494
(301) 707-4394
Mailing address
1952 NEW CREEK HWY, KEYSER, WV 26726-7494
(301) 707-4394
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
R195758
MD
Other
Enumeration date
10/21/2022
Last updated
10/21/2022
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