Provider Demographics
NPI:1457636888
Name:ABBOTT, JAMES DARRELL (ARNP)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:DARRELL
Last Name:ABBOTT
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 557 BOX 1151
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96379-1100
Mailing Address - Country:US
Mailing Address - Phone:0806-495-4367
Mailing Address - Fax:
Practice Address - Street 1:PSC 557 BOX 1151
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96379-1100
Practice Address - Country:US
Practice Address - Phone:0806-495-4367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-17
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60252663163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health