Doctor Name: | MS. MARY COLLINS DERIVAN |
NPI Number: | 1194848929 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN, MSN, AOCN |
License Number: | RN242255L |
Business Practice Address: | 229 Paperbirch Dr Collegeville, PA - 194262894 |
Business Phone Number: | 6104547721 |
Business Fax Number: | 6104547850 |
Mailing Address: | 229 Paperbirch Dr, COLLEGEVILLE |
State: | PA |
Postal Code: | 194262894 |
Phone Number: | 6104547721 |
Fax Number: | 6104547850 |
NPI Enumeration Date: | 04/08/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WX0200X |
License Number: | RN242255L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Oncology |
Taxonomy Definition: |