Provider Demographics
NPI:1255826368
Name:NIGHTINGALE, DARLA SUE (PTA)
Entity Type:Individual
Prefix:MISS
First Name:DARLA
Middle Name:SUE
Last Name:NIGHTINGALE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20143 16 SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:WELLSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43968-9615
Mailing Address - Country:US
Mailing Address - Phone:330-853-2101
Mailing Address - Fax:
Practice Address - Street 1:840 LEE ROAD
Practice Address - Street 2:
Practice Address - City:FOLLANSBEE
Practice Address - State:WV
Practice Address - Zip Code:26037
Practice Address - Country:US
Practice Address - Phone:304-527-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-30
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV001929225200000X
OH09059225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant