Individual provider · Type 1 NPI

Derrick Kyle Pelton, NP

Family Nurse Practitioner · Santa Rosa, CA

NPI number 1609208354 Active

Practice location

3883 Airway Dr Ste 120
Santa Rosa, CA 95403-1678

Fax (707) 573-5421

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X95012148 (CA)

Family Nurse Practitioner: Definition to come...

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About NPI 1609208354

Derrick Kyle Pelton, NP's National Provider Identifier is 1609208354, issued on Aug 5, 2013. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Santa Rosa, CA. The record was last updated on Feb 9, 2022.