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General NPI Number Information
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NPI Number | 1831882687
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Entity Type | Individual
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Provider Name | HYDIE MARIE DEROJAS
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Gender | Female
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Dates
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Enumeration Date | 05/30/2023
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Last Update Date | 07/21/2026
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Provider Practice Location Address
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Address Line | 575 N RIVER ST
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City | WILKES BARRE
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State | PA
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Zip | 18764-0999
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Country | US
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Telephone | 570-829-8111
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Fax |
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Provider Business Mailing Address
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Address Line | 2023 VADALABENE DR STE 300
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City | MARYVILLE
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State | IL
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Zip | 62062-5846
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Country | US
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Telephone | 618-855-1480
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN650321
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 112026-23
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License Number State | NH
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