MISS KELLY R DERINGTON APRN NPI 1083847404

NPI Information

NPI: 1083847404
Provider Name: MISS KELLY R DERINGTON, APRN
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
225 MEDICAL CENTER DR STE 301
PADUCAH, KY
ZIP 42003
Phone: (270) 441-4343
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MISS Kelly R Derington, APRN is a family nurse practitioner in Paducah, KY with 15 years of experience. MISS Kelly R Derington, APRN NPI is 1083847404. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

225 MEDICAL CENTER DR STE 301
PADUCAH, KY
ZIP 42003-915
Phone: (270) 441-4343
Fax: (270) 441-4344

The NPI 1083847404 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/2/2009 and was last updated on 6/6/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		1097839	KENTUCKY	No
2	363L00000X	Nurse Practitioner		3006215	KENTUCKY	No
3	363LF0000X	Nurse Practitioner	Family	3006215	KENTUCKY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000000632043	OTHER	KENTUCKY	ANTHEM
2	7100098570	MEDICAID	KENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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