Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 343829 | NY |
N | 363LP2300X | Nurse Practitioner - Primary Care | 9251690 | FL |
NPI | 1245717115 |
---|---|
Provider Name | Darlean James |
First Address | Malone, NY 12953-1244 |
Second Address | Malone, NY 12953 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2018 |
Last Update Date | 19/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1245717115 | (05) | NY |