Booth, Derek

Booth, Derek is an sole proprietor health care provider with primary practice located at 415 N 26Th St Suite 201, Lafayette IN 47904-2895. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as his primary health care specialty. Booth, Derek can be contacted via phone (765) 446-6577.

Contact Information

Primary practice address
415 N 26Th St Suite 201 Lafayette IN 47904-2895
Phone: (765) 446-6577
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 71005314B Indiana

Profile Details

NPI number 1568852986
LBN Legal business name Booth, Derek
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 24th, 2015
Last updated Jan 24th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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