Provider Demographics
NPI:1639651763
Name:KLATT, DARLA RENEE (RN)
Entity Type:Individual
Prefix:
First Name:DARLA
Middle Name:RENEE
Last Name:KLATT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4318 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79703-4855
Mailing Address - Country:US
Mailing Address - Phone:432-425-1825
Mailing Address - Fax:
Practice Address - Street 1:4318 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79703-4855
Practice Address - Country:US
Practice Address - Phone:432-425-1825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX882155163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics