Provider Demographics
NPI:1629343553
Name:YORK, DARLENE CARRIE ANNE (LPN)
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:CARRIE ANNE
Last Name:YORK
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17610 STATE ROUTE 136
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45697-9422
Mailing Address - Country:US
Mailing Address - Phone:937-690-9808
Mailing Address - Fax:
Practice Address - Street 1:3514 CURVING OAKS WAY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32820-2752
Practice Address - Country:US
Practice Address - Phone:937-690-9115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-10
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN-145431-MEDS164W00000X
FLPN5213562164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse