Individual
MS. SUSAN E MITCHELL-DERENSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
4901 FOREST PARK AVE, DIV OBGYN FAMILY PLANNING, STE 710, SAINT LOUIS, MO 63108-1495
(314) 362-4211
(888) 315-6494
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 362-4211
(888) 315-6494
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
2012036251
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420001391
—
MO
Enumeration date
10/01/2012
Last updated
04/17/2025
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