Individual
MR. KIRK ALLEN DEHERDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
1455 S LAPEER RD STE 100, LAKE ORION, MI 48360-1468
(248) 693-3551
Mailing address
1455 S LAPEER RD STE 100, LAKE ORION, MI 48360-1468
(248) 693-3551
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704327543
MI
Other
Enumeration date
01/05/2021
Last updated
02/23/2022
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