Healthcare Provider Details

I. General information

NPI: 1427975077
Provider Name (Legal Business Name): KIMBERLY M DERS AGPCNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 W 14TH ST BLDG 5TH
WILMINGTON DE
19801-1013
US

IV. Provider business mailing address

932 SCARLET OAK ST
MIDDLETOWN DE
19709-9116
US

V. Phone/Fax

Practice location:
  • Phone: 302-320-2620
  • Fax:
Mailing address:
  • Phone: 718-930-1168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberLP-0011080
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberLP-0011080
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberLP-0011080
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: