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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DERARTU FESSA HAYATO

Active

Long-Term Care Clinical Nurse Specialist · WHITE BEAR LAKE, MN

Registration Details

NPI Number
1912629890
Provider Type
Individual
Gender
Female
NPI Issued
Sep 16, 2022 (3.605991643739 yrs)
Last Updated
May 31, 2024
License
1109803 (MN)

Practice Information

Address
3857 VAN DYKE ST
WHITE BEAR LAKE, MN, 551104347
Browse MN providers · Browse ZIP 55110
Phone
9526887128
Primary Specialty
Long-Term Care Clinical Nurse Specialist
364SL0600X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.