Provider Demographics
NPI:1477749299
Name:ROMBOUGH, DARCY ANNE (RN)
Entity type:Individual
Prefix:MISS
First Name:DARCY
Middle Name:ANNE
Last Name:ROMBOUGH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4472 COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:HOLLEY
Mailing Address - State:NY
Mailing Address - Zip Code:14470-9601
Mailing Address - Country:US
Mailing Address - Phone:585-638-5527
Mailing Address - Fax:
Practice Address - Street 1:4472 COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:HOLLEY
Practice Address - State:NY
Practice Address - Zip Code:14470-9601
Practice Address - Country:US
Practice Address - Phone:585-638-5527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-16
Last Update Date:2007-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY499447-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02856839Medicaid