Provider Demographics
NPI:1295483212
Name:MURCIA, DERRICK
Entity type:Individual
Prefix:
First Name:DERRICK
Middle Name:
Last Name:MURCIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11735 E 6TH PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80010-4718
Mailing Address - Country:US
Mailing Address - Phone:318-617-5008
Mailing Address - Fax:
Practice Address - Street 1:11735 E 6TH PL
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80010-4718
Practice Address - Country:US
Practice Address - Phone:318-617-5008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-17
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program