Provider Demographics
NPI:1285848168
Name:PONTIUS, DARLENE M (LPN)
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:M
Last Name:PONTIUS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7756 GARDNER DR
Mailing Address - Street 2:#101
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-0644
Mailing Address - Country:US
Mailing Address - Phone:239-593-5209
Mailing Address - Fax:
Practice Address - Street 1:7756 GARDNER DR
Practice Address - Street 2:UNIT 101
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-0644
Practice Address - Country:US
Practice Address - Phone:239-593-5209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN1338001164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse