Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 201202988 | MO |
NPI | 1184976342 |
---|---|
Provider Name | Ashleigh Darnell |
First Address | Saint Louis, MO 63141-8221 |
Second Address | Saint Louis, MO 63141-8221 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2012 |
Last Update Date | 11/10/2012 |