Anastasia Deroussel, NP

NPI #1548793631 in Wagoner, Oklahoma

Provider Information

NPI Number: 1548793631
Entity Type: Individual
Name: Anastasia Deroussel, NP
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Registered Nurse
Credential: NP
Enumeration Date: Apr 6, 2017
Last Updated: Mar 10, 2023

Practice Location

Address: 1202 W CHEROKEE ST STE G
City: Wagoner
State: Oklahoma
ZIP Code: 74467-4629
Phone: (918) 914-5533

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Registered Nurse	163W00000X	Primary
Nurse Practitioner - Family — Family	363LF0000X
Nurse Practitioner - Gerontology — Gerontology	363LG0600X

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