Provider Demographics
NPI:1134631484
Name:DARTY, EVELYN NICHOL (LPN)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:NICHOL
Last Name:DARTY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11578 LINCOLNSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-2144
Mailing Address - Country:US
Mailing Address - Phone:513-904-3595
Mailing Address - Fax:
Practice Address - Street 1:11578 LINCOLNSHIRE DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-2144
Practice Address - Country:US
Practice Address - Phone:513-904-3595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.139463.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse