Most Relevant Information
Provider Data
| NPI Number: | 1003487992 |
| Provider Name: | JONELLE R DERK CRNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | SP023959 |
Most Important Dates
| Enumeration Date: | 07/02/2021 |
| Last Updated: | 07/14/2023 |
Provider Practice Location
111 S FRONT ST
HARRISBURG
PA
171012010
Practice Location Phone/Fax
| Phone: | 7177823380 |
| Fax: | 7177825716 |
Provider Mailing Location
111 S FRONT ST
HARRISBURG
PA
171012010
Provider Mailing Phone/Fax
| Phone: | 7177823380 |
| Fax: | 7177825716 |