Individual
ANN T DERGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN-C, APNP
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
1014-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000207365
MEDICARE
WI
01
—
STATE LICENSE
1014-033
WI
Enumeration date
09/20/2006
Last updated
03/07/2023
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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