MARY M DERKSEN CNS
NPI 1194749812
Nurse Practitioner - Psychiatric/Mental Health in Holland, MI

Active since July 26, 2006
12265 JAMES ST, HOLLAND, MI 49424(616) 494-5453 Get Directions Write a Review

NPPES record last updated: February 13, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mary M Derksen Cns NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY M DERKSEN CNS (NPI 1194749812) is an individual psychiatric/mental health provider in Holland, Michigan, licensed in Michigan (4704158809) and active in the NPI registry since July 2006.

NPPES Registry Identity

NPI1194749812
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameMARY M DERKSENCredential: CNS
Location Address12265 JAMES STHolland, MI 49424-8613
Mailing Address12265 James StHolland, MI 49424-8613 · (616) 494-5453
Sole ProprietorNo
Enumeration DateJuly 26, 2006
Last NPPES UpdateFebruary 13, 2012
NPI 1194749812 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License Licensed in MI · 4704158809
12265 JAMES ST, Holland, MI 49424

Other Identifiers 1

Medicare ID-Type Unspecified0G06004058MI · Medicare Number

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Registered Nurse (Psychiatric/Mental Health, Child & Adolescent)
12265 JAMES ST
HOLLAND, MI 49424
Social Worker (Clinical)
12265 JAMES ST
HOLLAND, MI 49424
Psychologist (Intellectual and Developmental Disabilities)
12265 JAMES ST
HOLLAND, MI 49424
Social Worker (Clinical)
12265 JAMES ST
HOLLAND, MI 49424
Social Worker (Clinical)
12265 JAMES ST
HOLLAND, MI 49424
Case Manager/Care Coordinator
12265 JAMES ST
HOLLAND, MI 49424
Registered Nurse (Psychiatric/Mental Health, Child & Adolescent)
12265 JAMES ST
HOLLAND, MI 49424
Case Manager/Care Coordinator
12265 JAMES ST
HOLLAND, MI 49424

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Derksen's NPI number?

The NPI number for Mary Derksen is 1194749812. It was assigned to this individual provider in the NPPES registry on July 26, 2006.

Where is Mary Derksen located?

Mary Derksen practices at 12265 James St, Holland, MI 49424. The listed phone number is (616) 494-5453.

What is Mary Derksen's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Mary Derksen was last updated on February 13, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.