MISS Kettly Derival, RN
NPI #1497903306 in North Baldwin, New York
Provider Information
- NPI Number
- 1497903306
- Entity Type
- Individual
- Name
- MISS Kettly Derival, RN
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Registered Nurse
- Credential
- RN
- Enumeration Date
- Sep 4, 2008
- Last Updated
- Sep 4, 2008
Practice Location
- Address
- 927 DE MOTT AVE
- City
- North Baldwin
- State
- New York
- ZIP Code
- 11510-1926
- Phone
- (516) 204-5518
Specialties & Taxonomy Codes
| Specialty |
|---|
| Registered Nurse |
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