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NPI Code Detail

MEDICARE: MRS. SARA LYNN DERRICK PMHNP-BC

MEDICARE:  MRS. SARA LYNN DERRICK  PMHNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner908326MS

General Provider Information

NPI Number : 1184565772
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SARA LYNN DERRICK PMHNP-BC
Provider Business Mailing Address
First Line : 1012 COUNTY ROAD 382
Second Line :
City : NEW ALBANY
State : MS
Zip : 38652-0017
Country : US
Telephone Number : 662-416-9246
Fax Number :
Provider Business Practice Location Address
First Line : 218 S DENTON RD
Second Line :
City : NEW ALBANY
State : MS
Zip : 38652-2810
Country : US
Telephone Number : 662-598-8141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2026
Last Update Date : 04/06/2026

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Directions to “ MRS. SARA LYNN DERRICK PMHNP-BC” Practice Location

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