Penny Deraps, FNP
Individual provider Active NPI Family Nurse Practitioner · Canaan, ME
NPI 1487743407 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1487743407
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R15754 (ME)
- Practice address
- 333 Main Street
Canaan, ME 04929 - Phone
- (207) 474-6990
- Fax
- (207) 474-8899
- NPI assigned
- Oct 11, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R15754 | ME | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sebasticook Family Doctors | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R15754 | ME | Yes |
Addresses
Primary practice location
333 Main Street
Canaan, ME 04929
Mailing address
118 Moosehead TRL
Suite 5
Newport, ME 04953-4020
Phone (207) 368-4213
Other providers in Canaan, ME
- Mary Ellen Banaszek
- John Gregory Bridges-Music
- Kathy Brooks-Rock
- David Brill
- Down to Earth Therapy
- Thomas Earley
- Jennifer L Giguere
- Melisa Ann Gilcott
- Tonya Marie Goucher
All providers in Canaan, ME · Family Nurse Practitioner in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.