Provider Demographics
NPI:1205862521
Name:MARKS, DARLENE (FNP)
Entity Type:Individual
Prefix:MS
First Name:DARLENE
Middle Name:
Last Name:MARKS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:DARLENE
Other - Middle Name:
Other - Last Name:MARKS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:166 FIFTH RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38483-8047
Mailing Address - Country:US
Mailing Address - Phone:808-557-8532
Mailing Address - Fax:
Practice Address - Street 1:166 FIFTH RD
Practice Address - Street 2:
Practice Address - City:SUMMERTOWN
Practice Address - State:TN
Practice Address - Zip Code:38483-8047
Practice Address - Country:US
Practice Address - Phone:808-557-8532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN40485363LF0000X
AK989363LF0000X
TN17658363LF0000X
CO0000082363LF0000X
NM961363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM961OtherNEW MEXICO BOARD OF NURSING
COANP-0000082OtherCOLORADO BOARD OF NURSING
AKAPRN989OtherALASKA BOARD OF NURSING
TNAPRN17658OtherTENNESSEE BOARD OF NURSING
HIAPRN651OtherHAWAII BOARD OF NURSING
COANP-0000082OtherCOLORADO BOARD OF NURSING