Provider Demographics
NPI:1578207866
Name:DARNELL, ALICIA LANICE
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:LANICE
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 1:3601 DRY BROOK RD APT S
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-0058
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3601 DRY BROOK RD APT S
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-0058
Practice Address - Country:US
Practice Address - Phone:563-320-5623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-24
Last Update Date:2022-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No261QP2400XAmbulatory Health Care FacilitiesClinic/CenterPrison Health
No376J00000XNursing Service Related ProvidersHomemaker