Mitchell-Derenski, Susan E
Mitchell-Derenski, Susan E is an individual health care provider with primary practice located at 4901 Forest Park Ave Div Obgyn Family Planning, Ste 710, Saint Louis MO 63108-1495. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Women's Health, which is considered as her primary health care specialty. Mitchell-Derenski, Susan E can be contacted via phone (314) 362-4211.Contact Information
Primary practice address
4901 Forest Park Ave Div Obgyn Family Planning, Ste 710
Saint Louis MO 63108-1495
Phone: (314) 362-4211
Fax: (888) 315-6494
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Women's Health | 363LW0102X | 2012036251 | Missouri |
Profile Details
| NPI number | 1629329578 |
|---|---|
| LBN Legal business name | Mitchell-Derenski, Susan E |
| Credentials | Women's Health Nurse Practitioner (WHNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 1st, 2012 |
| Last updated | Apr 17th, 2025 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629329578 | NPPES |
| Missouri | MEDICAID | 420001391 |
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