Individual provider · Type 1 NPI

Nicole Derose, CRNP

Primary Care Nurse Practitioner · Wynnewood, PA

NPI number 1922492735 Active

Practice location

100 E Lancaster Ave, Suite 230
Wynnewood, PA 19096-3450

Fax (610) 642-2943

Specialties and licenses

TaxonomyCodeLicense
Primary Care Nurse Practitioner Primary 363LP2300XSP014550 (PA)

Primary Care Nurse Practitioner: Definition to come...

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About NPI 1922492735

Nicole Derose, CRNP's National Provider Identifier is 1922492735, issued on Mar 19, 2015. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Wynnewood, PA. The record was last updated on Mar 19, 2015.