Individual provider · Type 1 NPI

Tory Deriso

Licensed Practical Nurse · Wixom, MI

NPI number 1730573247 Active

Practice location

27026 Meadowood Dr Apt 204
Wixom, MI 48393-3271

Call (248) 773-7687 Map

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000X4703108814 (MI)

Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

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About NPI 1730573247

Tory Deriso's National Provider Identifier is 1730573247, issued on Mar 23, 2015. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Wixom, MI. The record was last updated on Mar 23, 2015.