Provider Demographics
NPI:1184159048
Name:MONAGHAN, DARLYN
Entity type:Individual
Prefix:
First Name:DARLYN
Middle Name:
Last Name:MONAGHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 N JACKSONBURG RD STE A
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE CITY
Mailing Address - State:IN
Mailing Address - Zip Code:47327-9467
Mailing Address - Country:US
Mailing Address - Phone:765-478-9700
Mailing Address - Fax:765-478-9701
Practice Address - Street 1:1740 N JACKSONBURG RD STE A
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE CITY
Practice Address - State:IN
Practice Address - Zip Code:47327-9467
Practice Address - Country:US
Practice Address - Phone:765-478-9700
Practice Address - Fax:765-478-9701
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-27
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN27040661A164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse