MEDICARE: MRS. CATHERINE DERENONCOURT LPN

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
1	163W00000X	Registered Nurse	231020	AK
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	2026021962	AK
3	163W00000X	Registered Nurse	26NR17881800	NJ
4	163W00000X	Registered Nurse	RN305475	GA
5	163W00000X	Registered Nurse	695000	NY

General Provider Information

NPI Number	:	1619137486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CATHERINE DERENONCOURT LPN

Provider Business Mailing Address
First Line	:	44 W MAPLE AVE APT 1
Second Line	:
City	:	SUFFERN
State	:	NY
Zip	:	10901-5813
Country	:	US
Telephone Number	:	845-200-0151
Fax Number	:

Provider Business Practice Location Address
First Line	:	44 W MAPLE AVE APT 1
Second Line	:
City	:	SUFFERN
State	:	NY
Zip	:	10901-5813
Country	:	US
Telephone Number	:	845-200-0151
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2008
Last Update Date	:	04/13/2026

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Directions to “ MRS. CATHERINE DERENONCOURT LPN” Practice Location

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