Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mrs. Carole Anne Derucki, FNP-BC

Individual provider Specialist · NPI 1205809225

Mrs. Carole Anne Derucki, FNP-BC is a Nurse Practitioner in Saint Joseph, Michigan. Qualified in 2005, 21 years ago. Practices with Honor Physicians LLC, a 4-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Indiana and Michigan.

Years since qualifying
21
Licensed in
IN, MI
In the registry since
2006
Specialties on file
4
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

See every abbreviation used in this directory →

Practice location Address checks out

2900 Lakeview Ave
Saint Joseph, MI 49085-2379
Phone: (269) 932-7859
Fax: (269) 932-7859
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3809 N Main St Ste 100, Mishawaka, IN 46545-3109 — (574) 520-1700

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 4704166108 (MI)
Specialist Taxonomy 174400000X · Licence 71002723A (IN)
Nurse Practitioner Taxonomy 363L00000X · Licence 4704166108 (MI)
Nurse Practitioner Taxonomy 363L00000X · Licence 71002723A (IN)

Record details

NPI number1205809225
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-BC
Sole proprietorNo
NPI enumeratedFebruary 9, 2006
Last updated in NPPESFebruary 29, 2024
Certification dateFebruary 29, 2024

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Honor Physicians Llc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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