National Provider Identifier
Derek John Carlson, RN
Derek John Carlson, RN is listed in the NPPES registry with a primary specialty of Registered Nurse in Canandaigua, NY and a listed phone number of (585) 394-0530.
Profile Overview
- NPI
- 1922547314
- Provider Type
- Individual
- Primary Specialty
- Registered Nurse
- Enumeration Date
- February 17, 2017
- Last Updated
- February 17, 2017
Practice Location
- 35 North St
- Canandaigua, NY 14424-1075
Phone: (585) 394-0530
Mailing Address
- 2512 State Route 5 And 20
- Stanley, NY 14561-9521
Specialties
- Registered Nurse (163W00000X)
Full Record
- NPI
- 1922547314
- Entity Type
- Individual
- Last Name
- Carlson
- First Name
- Derek
- Middle Name
- John
- Name Prefix
- Mr.
- Credential
- RN
- Mailing Street Address
- 2512 State Route 5 And 20
- Mailing City
- Stanley
- Mailing State
- NY
- Mailing ZIP Code
- 14561-9521
- Mailing Country
- US
- Mailing Phone
- (315) 759-0476
- Practice Street Address
- 35 North St
- Practice City
- Canandaigua
- Practice State
- NY
- Practice ZIP Code
- 14424-1075
- Practice Country
- US
- Practice Phone
- (585) 394-0530
- Practice Fax
- (585) 394-3872
- Enumeration Date
- February 17, 2017
- Last Updated
- February 17, 2017
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Registered Nurse (163W00000X)