Individual
JULIA MICHELLE DERUYTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2301 ERWIN RD, DURHAM, NC 27705-4699
(919) 681-6809
Mailing address
3109 SYNNOTTS PL, DURHAM, NC 27705-1403
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5016479
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3OR78MSX
RN LICENSE
NC
Enumeration date
07/15/2020
Last updated
07/06/2022
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