Provider Demographics
NPI:1578892626
Name:PHELAN, DARCY (RN, NP)
Entity Type:Individual
Prefix:
First Name:DARCY
Middle Name:
Last Name:PHELAN
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 PARNASSUS AVE
Mailing Address - Street 2:MOFFITT HOSPITAL, BOX 0106
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-2621
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:650 PARNASSUS AVE
Practice Address - Street 2:MOFFITT HOSPITAL, BOX 0106
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-2621
Practice Address - Country:US
Practice Address - Phone:415-476-6794
Practice Address - Fax:415-476-3301
Is Sole Proprietor?:No
Enumeration Date:2009-12-21
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19064363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health