Derylene Proctor
Case Manager/Care Coordinator in Monticello, FL(View on Map)
Full Name
Derylene Proctor
NPI Number
1710351986
NPI Type
Individual Provider
Gender
Female
Enumeration Date
11/25/2015
Specialties
(Taxonomies)Name
Code
171M00000X
101YA0400X
101Y00000X
101YM0800X
Primary Taxonomy
Yes
No
No
No
Licenses
State
Florida
License Number
AC# 6530425
Contact
Information
Purpose
Mailing
Location
Address
5773 N SALT RD
5773 N SALT RD
City
Monticello
Monticello
State
FL
FL
Postal Code
32344-5173
32344-5173
Country
US
US
Telephone Number
(850) 544-3045
(850) 544-3045
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 11/25/2015