Individual provider · Type 1 NPI
Peggy Anne Derusso, CRNP
Primary Care Nurse Practitioner · Philadelphia, PA
NPI number
1144860735
Active
Practice location
7505 Bustleton Ave
Philadelphia, PA 19152-4136
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Nurse Practitioner Primary | 363LP2300X | SP021349 (PA) |
Primary Care Nurse Practitioner: Definition to come...
2 other providers at this address
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About NPI 1144860735
Peggy Anne Derusso, CRNP's National Provider Identifier is 1144860735, issued on Jan 10, 2020. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Philadelphia, PA. The record was last updated on Jan 10, 2020.