Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dawn Marie Derks, ACNS-BC, PMHNP-BC

Individual provider Adult Health Clinical Nurse Specialist · NPI 1396147377

Dawn Marie Derks, ACNS-BC, PMHNP-BC is a Nurse Practitioner in Saint Paul, Minnesota. Qualified in 2023, 3 years ago. Practices with Memorial Medical Center Inc, a 78-clinician group and accepts Medicare assignment. Licensed in Minnesota and Wisconsin.

Years since qualifying
3
Licensed in
MN, WI
In the registry since
2014
Specialties on file
2
What do these letters mean?
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.

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Practice location Address checks out

640 Jackson St
Saint Paul, MN 55101-2502
Phone: (651) 254-3665
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 15001-33 (WI)
Adult Health Clinical Nurse Specialist Taxonomy 364SA2200X · Licence 2014005854 (MN)

Record details

NPI number1396147377
Entity typeIndividual (Type 1)
GenderFemale
Credentials ACNS-BC , PMHNP-BC
Sole proprietorNo
NPI enumeratedSeptember 21, 2014
Last updated in NPPESFebruary 9, 2024
Certification dateFebruary 9, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Memorial Medical Center Inc — 78 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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