Provider Demographics
NPI:1659456598
Name:MATHISON, DARCI M (ARNP)
Entity Type:Individual
Prefix:
First Name:DARCI
Middle Name:M
Last Name:MATHISON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:802 W DRAKE RD
Mailing Address - Street 2:STE 101
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-5567
Mailing Address - Country:US
Mailing Address - Phone:970-482-0198
Mailing Address - Fax:
Practice Address - Street 1:7301 E FRONTAGE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SHAWNEE MISSION
Practice Address - State:KS
Practice Address - Zip Code:66204-1654
Practice Address - Country:US
Practice Address - Phone:913-384-4040
Practice Address - Fax:913-384-4093
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO0369099363LF0000X
KS45457363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily