Provider Demographics
NPI:1497762363
Name:DARROW, CARLA MARIE (FNP)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:MARIE
Last Name:DARROW
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1250
Mailing Address - Street 2:
Mailing Address - City:GLOVERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12078-0010
Mailing Address - Country:US
Mailing Address - Phone:518-775-4205
Mailing Address - Fax:518-775-4225
Practice Address - Street 1:ROUTE 8
Practice Address - Street 2:BOX 46
Practice Address - City:SPECULATOR
Practice Address - State:NY
Practice Address - Zip Code:12164
Practice Address - Country:US
Practice Address - Phone:518-548-8155
Practice Address - Fax:518-548-4819
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF330943363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01518309Medicaid
NYBB6842Medicare ID - Type Unspecified
NYS89202Medicare UPIN