| Doctor Name: | DEREK PRZYBYLSKI |
| NPI Number: | 1003265349 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | R 235077-4 |
| Business Practice Address: | 2525 Chicago Ave Minneapolis, MN - 554044518 |
| Business Phone Number: | 7152079330 |
| Business Fax Number: | |
| Mailing Address: | 1174 Shadow Ln, GREEN BAY |
| State: | WI |
| Postal Code: | 543043942 |
| Phone Number: | 7152079330 |
| Fax Number: | |
| NPI Enumeration Date: | 06/07/2016 |
| NPI Last Update Date: | 06/07/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LN0000X |
| License Number: | R 235077-4 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Neonatal |
| Taxonomy Definition: | |