Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 95017964 | CA |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 95017964 | CA |
NPI | 1497426928 |
---|---|
Provider Name | Lisa Darden |
First Address | Corona, CA 92879-7895 |
Second Address | Colton, CA 92324-1801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2021 |
Last Update Date | 23/09/2021 |