Provider Demographics
NPI:1396187068
Name:DARRAH, LIZABETH ANN (CNP)
Entity Type:Individual
Prefix:
First Name:LIZABETH
Middle Name:ANN
Last Name:DARRAH
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 SOTHERN BLVD.
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-1221
Mailing Address - Country:US
Mailing Address - Phone:937-752-2304
Mailing Address - Fax:937-522-7620
Practice Address - Street 1:3535 SOUTHERN BLVD
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-1221
Practice Address - Country:US
Practice Address - Phone:937-395-8056
Practice Address - Fax:937-395-8145
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.14917363L00000X
OH14917-NP363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner