Provider Demographics
NPI:1033462049
Name:DERENSKI, RACHEL LYNN (CNP)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:LYNN
Last Name:DERENSKI
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10506A MONTGOMERY RD STE 300
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:OH
Mailing Address - Zip Code:45242-4402
Mailing Address - Country:US
Mailing Address - Phone:513-865-5120
Mailing Address - Fax:513-246-4047
Practice Address - Street 1:10506A MONTGOMERY RD STE 300
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:OH
Practice Address - Zip Code:45242-4402
Practice Address - Country:US
Practice Address - Phone:513-865-5120
Practice Address - Fax:513-246-4047
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA13849NP363L00000X, 363LA2100X
OHCOA.13849-NP363LA2100X
MO2016001452363LA2100X
OHAPRN.CNP.13849363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner