Provider Demographics
NPI:1114493012
Name:DARR, EMILY S (FNP)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:S
Last Name:DARR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SAN JOSE VLG
Mailing Address - Street 2:
Mailing Address - City:TINIAN
Mailing Address - State:NMI
Mailing Address - Zip Code:96952
Mailing Address - Country:UM
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 SAN JOSE VLG
Practice Address - Street 2:
Practice Address - City:TINIAN
Practice Address - State:NMI
Practice Address - Zip Code:96952
Practice Address - Country:UM
Practice Address - Phone:670-286-2606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-17
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MPF10180377363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner