Provider Demographics
NPI:1932838828
Name:DERSCHEID, CINDY L (REGISTERED NURSE BSN)
Entity type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:L
Last Name:DERSCHEID
Suffix:
Gender:F
Credentials:REGISTERED NURSE BSN
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:L
Other - Last Name:DERSCHEID
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:8444 OAK RD
Mailing Address - Street 2:
Mailing Address - City:EVART
Mailing Address - State:MI
Mailing Address - Zip Code:49631-8088
Mailing Address - Country:US
Mailing Address - Phone:231-734-2045
Mailing Address - Fax:
Practice Address - Street 1:8444 OAK RD
Practice Address - Street 2:
Practice Address - City:EVART
Practice Address - State:MI
Practice Address - Zip Code:49631-8088
Practice Address - Country:US
Practice Address - Phone:231-734-2045
Practice Address - Fax:231-734-2282
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704138956163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent