Provider Demographics
NPI:1255538146
Name:MERRILL, DARLENE MAXFIELD (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:MAXFIELD
Last Name:MERRILL
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:2075 ALTURAS RD
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-1102
Mailing Address - Country:US
Mailing Address - Phone:805-462-9190
Mailing Address - Fax:805-462-8069
Practice Address - Street 1:9700 EL CAMINO REAL
Practice Address - Street 2:STE. 1200 WEST TOWER
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-5569
Practice Address - Country:US
Practice Address - Phone:805-466-1330
Practice Address - Fax:805-466-1654
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA306986363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily