Provider Demographics
NPI:1881853141
Name:HOLBERT, DARLENE HATTIE (RN)
Entity Type:Individual
Prefix:MS
First Name:DARLENE
Middle Name:HATTIE
Last Name:HOLBERT
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 1:700 W 23RD ST
Mailing Address - Street 2:# G59
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-3936
Mailing Address - Country:US
Mailing Address - Phone:850-872-4700
Mailing Address - Fax:850-872-4719
Practice Address - Street 1:700 W 23RD ST
Practice Address - Street 2:#G59
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-3936
Practice Address - Country:US
Practice Address - Phone:850-872-4700
Practice Address - Fax:850-872-4719
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2082382163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management