Provider Demographics
NPI:1477870012
Name:DARNELL, STEPHANIE WRIGHT
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:WRIGHT
Last Name:DARNELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 WYNDAMERE LN
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:KY
Mailing Address - Zip Code:40361-2153
Mailing Address - Country:US
Mailing Address - Phone:859-987-9198
Mailing Address - Fax:
Practice Address - Street 1:13201 MAGISTERIAL DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-4105
Practice Address - Country:US
Practice Address - Phone:502-244-6770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY003243225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist