Kenyonne Derrick

NPI 1932961711 · on the registry since 2024 · sole proprietor

Practice

Address: 4009 Eufaula Ave
Muskogee, OK 74403
Phone: (918) 682-2841
Organisation at this address: Muskogee County Council Of Youth Service
Muskogee County Council Of Youth Services
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 23

Registry record

Primary taxonomy: 171400000X
171400000X
Also registered as: 103TC1900X
Licence states on file: OK
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2024-01-26

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oklahoma