Provider Demographics
NPI:1134622871
Name:DERKYI, ALBERTA (CRNP)
Entity type:Individual
Prefix:
First Name:ALBERTA
Middle Name:
Last Name:DERKYI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3404 BITTERWOOD PLACE, #I003
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724
Mailing Address - Country:US
Mailing Address - Phone:502-319-0090
Mailing Address - Fax:
Practice Address - Street 1:3404 BITTERWOOD PLACE, #I003
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20724
Practice Address - Country:US
Practice Address - Phone:502-319-0090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-08
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR206074363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily