Individual
KIRSTEN BAILEY DERICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3211 GRANT LINE RD STE 15, NEW ALBANY, IN 47150-2175
(812) 221-1186
(949) 882-0452
Mailing address
3211 GRANT LINE RD STE 15, NEW ALBANY, IN 47150-2175
(812) 221-1186
(949) 882-0452
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
07/13/2023
Last updated
04/09/2026
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