Individual
TERRY A MARLEY-DEROSIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHCNP
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
R019043
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040638
BLUE CROSS BLUE SHIELD
ME
01
—
2351291
AETNA HMO
ME
01
—
7493084
AETNA NON-HMO
ME
01
—
MN3827
HARVARD PILGRIM
ME
Enumeration date
11/03/2005
Last updated
07/18/2007
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