Derrick, Allyson
Derrick, Allyson is an individual health care provider with primary practice located at 1 Richland Medical Park Dr Ste 300 , Columbia SC 29203-6831. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Student, Health Care / Student in an Organized Health Care Education/Training Program. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is her primary health care specialty. Derrick, Allyson can be contacted via phone (803) 545-5500.Contact Information
Primary practice address
1 Richland Medical Park Dr Ste 300
Columbia SC 29203-6831
Phone: (803) 545-5500
Fax: (803) 933-3022
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Acute Care | 363LA2100X | 24420 | South Carolina |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X |
Profile Details
| NPI number | 1053933267 |
|---|---|
| LBN Legal business name | Derrick, Allyson |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 11th, 2020 |
| Last updated | Mar 2nd, 2021 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053933267 | NPPES |
| South Carolina | MEDICAID | NP7372 |
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