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NPI Code Detail

MEDICARE: MS. KIMBERLY M DERS AGPCNP-BC

MEDICARE: MS. KIMBERLY M DERS AGPCNP-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
1363LA2200XAdult Health Nurse Practitioner363LA2200XDE
2363LG0600XGerontology Nurse Practitioner363LG0600XDE
3363LP2300XPrimary Care Nurse Practitioner363L00000XDE

General Provider Information

NPI Number : 1427975077
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KIMBERLY M DERS AGPCNP-BC
Provider Business Mailing Address
First Line : 932 SCARLET OAK ST
Second Line :
City : MIDDLETOWN
State : DE
Zip : 19709-9116
Country : US
Telephone Number : 718-930-1168
Fax Number :
Provider Business Practice Location Address
First Line : 501 W 14TH ST BLDG 5TH
Second Line :
City : WILMINGTON
State : DE
Zip : 19801-1013
Country : US
Telephone Number : 302-320-2620
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2026
Last Update Date : 07/03/2026

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