Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Mary Anne Derrico, APRN-CNP

Individual provider Family Nurse Practitioner · NPI 1245581974

Mrs. Mary Anne Derrico, APRN-CNP is a Nurse Practitioner in Elgin, Oklahoma. Qualified in 2012, 14 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
14
Licensed in
OK
In the registry since
2012
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Practice location Address checks out

13631 NE Townley Rd
Elgin, OK 73538-3705
Phone: (580) 512-0746
Fax: (580) 250-0506
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 49043 (OK)

Record details

NPI number1245581974
Entity typeIndividual (Type 1)
GenderFemale
Credentials APRN-CNP
Sole proprietorYes
NPI enumeratedSeptember 20, 2012
Last updated in NPPESMarch 8, 2013

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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