Provider Demographics
NPI:1407161615
Name:REDD, DARNICA N (LPN)
Entity Type:Individual
Prefix:
First Name:DARNICA
Middle Name:N
Last Name:REDD
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 1:118 SPARKS ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45426-3017
Mailing Address - Country:US
Mailing Address - Phone:937-380-6097
Mailing Address - Fax:
Practice Address - Street 1:118 SPARKS ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45426-3017
Practice Address - Country:US
Practice Address - Phone:937-380-6097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH129941164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse