Dericka Canada

NPI 1104120781 - Student in an Organized Health Care Education/Training Program - 390200000X

NPI Details
NPI 1104120781
Gender Female
Enumeration Date 12/22/2010
Last Updated 12/22/2010
Entity Type Individual
Active Over 5 years ago
Practice Location
914 E BROADWAY
LOUISVILLE KY, 40204-1037, US
Phone (502) 589-8600
Fax (502) 589-8771
Business Location
101 W MUHAMMAD ALI BLVD
LOUISVILLE KY, 40202-1423, US
Phone
Fax
Toxanomy
Taxonomy Code 390200000X
License State
License Number
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According to our database, Dericka Canada NPI is 1104120781, taxonomy code is 390200000X Dericka Canada physically located at 914 E Broadway, Louisville KY, 40204-1037. NPI Number Dericka Canada has the Individual type.

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1104120781 NPI number is provided on an as is basis without warranty of any kind. 1104120781 is maintained by the National Plan & Provider Enumeration System. The contents of Dericka Canada are for informational purposes only.