Derks, Dawn Marie
Derks, Dawn Marie is an individual health care provider with primary practice located at 640 Jackson St , Saint Paul MN 55101-2502. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Derks, Dawn Marie can be contacted via phone (651) 254-3665.Contact Information
Primary practice address
640 Jackson St
Saint Paul MN 55101-2502
Phone: (651) 254-3665
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 364SA2200X | 2014005854 | Minnesota |
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 15001-33 | Wisconsin |
Profile Details
NPI number | 1396147377 |
---|---|
LBN Legal business name | Derks, Dawn Marie |
Credentials | ACNS-BC, PMHNP-BC |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Sep 21st, 2014 |
Last updated | Feb 9th, 2024 - about 7 months 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1396147377 | NPPES |
Minnesota | Other | C02467 | MEDICARE |
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