Individual
CAROL DERWACTER
Active
Individual
CAROL DERWACTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.N.P.
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
NP04044
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080146341
MEDICARE RAILROAD
OH
01
—
0989499
GROUP MEDICAID
OH
05
—
2043354
—
OH
01
—
311413469060
CARESOURCE PIN
OH
01
—
CA1586
GROUP MEDICARE RAILROAD
—
01
—
DENP03501
MEDICARE PTAN
—
Enumeration date
12/19/2005
Last updated
08/19/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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