Provider Demographics
NPI:1619021680
Name:DARR, ELLEN M
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:M
Last Name:DARR
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 1:121 N SEMINOLE DR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-2608
Mailing Address - Country:US
Mailing Address - Phone:423-266-6751
Mailing Address - Fax:423-763-4662
Practice Address - Street 1:1028 E 3RD ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2107
Practice Address - Country:US
Practice Address - Phone:423-266-6751
Practice Address - Fax:423-763-4662
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
TN161904163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator