Derek Booth
Derek Booth is a Psychiatric/Mental Health Nurse Practitioner in Lafayette, Indiana. Practices as a sole proprietor. Licensed in Indiana.
- Licensed in
- IN
- In the registry since
- 2015
Practice location Address checks out
415 N 26th St Ste 201Lafayette, IN 47904-2895
Phone: (765) 446-6577
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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 71005314B (IN) |
|---|
Record details
| NPI number | 1568852986 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | January 24, 2015 |
| Last updated in NPPES | January 24, 2015 |
| Mailing address | 415 N 26th St, Suite 201, Lafayette, IN 47904-2895 |
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