Basic Information
Provider Information
NPI: 1417159369
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DARNELL
FirstName: JOYCE
MiddleName: DIANE
NamePrefix:  
NameSuffix:  
Credential: CFNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 237 W 900 N
Address2:  
City: RUSHVILLE
State: IN
PostalCode: 461739083
CountryCode: US
TelephoneNumber: 7656455135
FaxNumber:  
Practice Location
Address1: 509 CONRAD HARCOURT WAY
Address2:  
City: RUSHVILLE
State: IN
PostalCode: 461731165
CountryCode: US
TelephoneNumber: 7659323699
FaxNumber: 7659324164
Other Information
ProviderEnumerationDate: 06/04/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X71000504AINY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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