Provider Demographics
NPI:1750197687
Name:REMY, DEREK ROBERT (RN)
Entity type:Individual
Prefix:MR
First Name:DEREK
Middle Name:ROBERT
Last Name:REMY
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 WILBRAHAM RD
Mailing Address - Street 2:
Mailing Address - City:HAMPDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01036-9760
Mailing Address - Country:US
Mailing Address - Phone:413-883-3923
Mailing Address - Fax:
Practice Address - Street 1:209 WILBRAHAM RD
Practice Address - Street 2:
Practice Address - City:HAMPDEN
Practice Address - State:MA
Practice Address - Zip Code:01036-9760
Practice Address - Country:US
Practice Address - Phone:413-883-3923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2325689163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse