Provider Demographics
NPI:1992000954
Name:REAKA ISRAEL, DARLENE L (MSN, CRNP)
Entity Type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:L
Last Name:REAKA ISRAEL
Suffix:
Gender:F
Credentials:MSN, CRNP
Other - Prefix:MISS
Other - First Name:DARLENE
Other - Middle Name:L
Other - Last Name:REAKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, CRNP
Mailing Address - Street 1:23 CHARTLEY PARK RD
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136
Mailing Address - Country:US
Mailing Address - Phone:410-833-2949
Mailing Address - Fax:410-833-3136
Practice Address - Street 1:23 CHARTLEY PARK RD
Practice Address - Street 2:
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136
Practice Address - Country:US
Practice Address - Phone:410-833-2949
Practice Address - Fax:410-833-3136
Is Sole Proprietor?:No
Enumeration Date:2011-01-21
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR116499363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics