Individual
DERICK DUCKWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3327 N CASALOMA DR UNIT 197, APPLETON, WI 54913-7963
(360) 620-2644
Mailing address
3327 N CASALOMA DR UNIT 197, APPLETON, WI 54913-7963
(360) 620-2644
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
261171
WI
Other
Enumeration date
10/19/2023
Last updated
10/19/2023
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