Provider Demographics
NPI:1093049140
Name:SPLAWN, DARLA JEAN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:DARLA
Middle Name:JEAN
Last Name:SPLAWN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DARLA
Other - Middle Name:JEAN
Other - Last Name:KYLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:305 EAST CENTER AVENUE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-6331
Mailing Address - Country:US
Mailing Address - Phone:559-791-7000
Mailing Address - Fax:559-781-8193
Practice Address - Street 1:1107 WEST POPLAR AVE.
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-5839
Practice Address - Country:US
Practice Address - Phone:559-781-7242
Practice Address - Fax:559-793-3542
Is Sole Proprietor?:No
Enumeration Date:2009-09-22
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20530363AM0700X
CAPA20530363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACK556ZMedicare UPIN