Individual
MRS. KIWANA N DERRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, AGNP-C
Contact information
Practice address
835 UNION ST, SHELBYVILLE, TN 37160-2607
(931) 680-2300
Mailing address
PO BOX 2182, LEWISBURG, TN 37091-1182
(931) 652-2521
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
196202
TN
363L00000X
Nurse Practitioner
Primary
APN0000028011
TN
Other
Enumeration date
08/17/2020
Last updated
05/04/2026
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