1235329137 NPI number — MS. LAURA GRACE DARBY RN,C-FNP

Table of content: MS. LAURA GRACE DARBY RN,C-FNP (NPI 1235329137)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235329137 NPI number — MS. LAURA GRACE DARBY RN,C-FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DARBY
Provider First Name:
LAURA
Provider Middle Name:
GRACE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RN,C-FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DARBY
Provider Other First Name:
LAURA
Provider Other Middle Name:
G.
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN, C-FNP
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1235329137
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/26/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1448 10TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTINGTON
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25701-3581
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-529-0753
Provider Business Mailing Address Fax Number:
304-529-0591

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1448 10TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTINGTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25701-3581
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-259-0753
Provider Business Practice Location Address Fax Number:
304-529-0591
Provider Enumeration Date:
07/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  29283 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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