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General NPI Number Information
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NPI Number | 1710695408
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Entity Type | Organization
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Legal Business Name | DNP-DERM LLC
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Dates
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Enumeration Date | 11/10/2022
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Last Update Date | 01/20/2023
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Provider Practice Location Address
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Address Line | 2501 WALDEN WOODS DR # 4087
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City | PLANT CITY
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State | FL
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Zip | 33566-7168
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Country | US
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Telephone | 813-330-0106
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Fax | 833-464-3525
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Provider Business Mailing Address
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Address Line | 2501 WALDEN WOODS DR # 4087
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City | PLANT CITY
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State | FL
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Zip | 33566-9998
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Country | US
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Telephone | 813-330-0106
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Fax | 833-464-3525
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Authorized Official
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Title or Position | CEO & FOUNDER
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Name | DR. KEISCHA N CASH
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Credential | DNP
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Telephone | 315-882-2967
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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