Provider Demographics
NPI:1447920020
Name:DERSTINE, BRITTA M (RN)
Entity type:Individual
Prefix:
First Name:BRITTA
Middle Name:M
Last Name:DERSTINE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 DORCHESTER LN
Mailing Address - Street 2:
Mailing Address - City:PERKASIE
Mailing Address - State:PA
Mailing Address - Zip Code:18944-1885
Mailing Address - Country:US
Mailing Address - Phone:215-206-4288
Mailing Address - Fax:
Practice Address - Street 1:519 CONSTITUTION AVE
Practice Address - Street 2:
Practice Address - City:PERKASIE
Practice Address - State:PA
Practice Address - Zip Code:18944-1248
Practice Address - Country:US
Practice Address - Phone:215-206-4288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN649497163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty