Deroussel, Anastasia
Deroussel, Anastasia is an individual health care provider with primary practice located at 1202 W Cherokee St Ste G , Wagoner OK 74467-4629. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Deroussel, Anastasia can be contacted via phone (918) 914-5533.Contact Information
Primary practice address
1202 W Cherokee St Ste G
Wagoner OK 74467-4629
Phone: (918) 914-5533
Fax: (918) 485-6020
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Registered Nurse | 163W00000X | 727314-1 | New York |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | F341382-1 | New York |
| Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | R0129494 | Oklahoma |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | R0129494 | Oklahoma |
Profile Details
| NPI number | 1548793631 |
|---|---|
| LBN Legal business name | Deroussel, Anastasia |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 6th, 2017 |
| Last updated | Mar 10th, 2023 - about 3 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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