Derks, Dawn Marie

Derks, Dawn Marie is an individual health care provider with primary practice located at 640 Jackson St , Saint Paul MN 55101-2502. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Derks, Dawn Marie can be contacted via phone (651) 254-3665.

Contact Information

Primary practice address
640 Jackson St Saint Paul MN 55101-2502
Phone: (651) 254-3665
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 364SA2200X 2014005854 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 15001-33 Wisconsin

Profile Details

NPI number 1396147377
LBN Legal business name Derks, Dawn Marie
Credentials ACNS-BC, PMHNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2014
Last updated Feb 9th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396147377 NPPES
Minnesota Other C02467 MEDICARE

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