Constance Jeanne Derungs

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R 069317-4 Issued in MN

Practice address

525 S Lake Ave
Suite 222
Duluth, MN 55802-2300

Phone

(218) 279-8372

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Constance Jeanne Branham & Eller Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679685127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 S LAKE AVE",
            "address_2": "SUITE 222",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022300",
            "telephone_number": "218-279-8372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 S LAKE AVE",
            "address_2": "SUITE 222",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022300",
            "telephone_number": "218-279-8372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERUNGS",
        "first_name": "CONSTANCE",
        "middle_name": "JEANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R 069317-4",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONSTANCE",
            "last_name": "BRANHAM & ELLER",
            "middle_name": "JEANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Derin J Van Loon OD PA
• Dermatology Duluth LLC
• Dale Edward Derocher, MS
• Kristy Lynn Derosia, R.D.H
• Cathy Jo Derosier, RN
• Christine Helen Desjardins, PHARMD
• Kirsten Lee Desmarais, PT
• Christa H Deters, OTR
• Chloe Deutsch
• John Christopher Deutsch

• Registered Nurse in Duluth, MN
• Providers in Duluth, MN by specialty
• Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.