Provider Demographics
NPI:1609266154
Name:LANDERS, DARCIA M (MA)
Entity Type:Individual
Prefix:MRS
First Name:DARCIA
Middle Name:M
Last Name:LANDERS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:DARCIA
Other - Middle Name:M
Other - Last Name:LANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:32 CLARK STREET
Mailing Address - Street 2:APT A
Mailing Address - City:WINTHROP
Mailing Address - State:ME
Mailing Address - Zip Code:04364
Mailing Address - Country:US
Mailing Address - Phone:207-395-5166
Mailing Address - Fax:
Practice Address - Street 1:32 CLARK STREET
Practice Address - Street 2:APT A
Practice Address - City:WINTHROP
Practice Address - State:ME
Practice Address - Zip Code:04364
Practice Address - Country:US
Practice Address - Phone:207-395-5166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-04
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide