| Kelly M Derise, | |
|
1900 Gravier St, New Orleans, LA 70112-2262 | |
| (504) 568-4106 | |
| Not Available |
| Full Name | Kelly M Derise |
|---|---|
| Gender | Female |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 1 Years |
| Location | 1900 Gravier St, New Orleans, Louisiana |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427867316 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 985451 (New York) | Primary |
| 163WC0200X | Registered Nurse - Critical Care Medicine | 205692 (Louisiana) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| New York University Langone Medical Center | New york, NY | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| New York University | 1355232422 | 5805 |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly M Derise, 423 Oak Manor Dr, New Iberia, LA 70563-2243 Ph: (337) 380-0161 | Kelly M Derise, 1900 Gravier St, New Orleans, LA 70112-2262 Ph: (504) 568-4106 |
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