Provider Demographics
NPI:1609421387
Name:MASSEY, DARCY LANEL
Entity Type:Individual
Prefix:
First Name:DARCY
Middle Name:LANEL
Last Name:MASSEY
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 1:6511 WHITESTOWN PKWY
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-7621
Mailing Address - Country:US
Mailing Address - Phone:317-769-5986
Mailing Address - Fax:317-769-6075
Practice Address - Street 1:6511 WHITESTOWN PKWY
Practice Address - Street 2:
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077-7621
Practice Address - Country:US
Practice Address - Phone:317-769-5986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-08
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26021762A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist