Provider Demographics
NPI:1851308647
Name:MCCUTCHEON, DARCEEN J (NP)
Entity Type:Individual
Prefix:
First Name:DARCEEN
Middle Name:J
Last Name:MCCUTCHEON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 E 54TH ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-7209
Mailing Address - Country:US
Mailing Address - Phone:563-421-0550
Mailing Address - Fax:
Practice Address - Street 1:1801 E 54TH ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-7209
Practice Address - Country:US
Practice Address - Phone:563-421-0550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2021-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX745387363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care