Jennifer Derham
Individual provider Active NPI Home Health Registered Nurse · Keyser, WV
NPI 1609593516 · NPPES record last updated Oct 21, 2022
Key facts
- NPI
- 1609593516
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Registered Nurse 163WH0200X
- License
- R195758 (MD)
- Practice address
- 1952 New Creek Hwy
Keyser, WV 26726-7494 - Phone
- (301) 707-4394
- NPI assigned
- Oct 21, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R195758 | MD | MD | Home Health Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | R195758 | MD | Yes |
Addresses
Primary practice location
1952 New Creek Hwy
Keyser, WV 26726-7494
Mailing address
1952 New Creek Hwy
Keyser, WV 26726-7494
Phone (301) 707-4394
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | jennifer.derham1@wvumedicine.org | Other |
Other providers in Keyser, WV
- Chloe Alyvea Delawder
- Amy Delsignore
- Marie Delsignore
- Debra A Deniker
- Thomas Carl Denne
- Developmental Center & Workshop, Inc.
- Tiffany Diehl
- Marcia Lynn Dieterle
- Rose Dixon
- Brianna Deshawn Dobbs
All providers in Keyser, WV · Home Health Registered Nurse in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2022. 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.