Provider Demographics
NPI:1952444986
Name:HUSOME, DARRA A (FNP, CNS)
Entity Type:Individual
Prefix:MS
First Name:DARRA
Middle Name:A
Last Name:HUSOME
Suffix:
Gender:F
Credentials:FNP, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21445 CHIPMUNK LN
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-8799
Mailing Address - Country:US
Mailing Address - Phone:530-549-5778
Mailing Address - Fax:
Practice Address - Street 1:29632 HIGHWAY 299 EAST
Practice Address - Street 2:
Practice Address - City:ROUND MOUNTAIN
Practice Address - State:CA
Practice Address - Zip Code:96084
Practice Address - Country:US
Practice Address - Phone:530-337-6243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA516365363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily