Provider Demographics
NPI:1669420774
Name:EISENHAUER, DARLA (MD)
Entity type:Individual
Prefix:
First Name:DARLA
Middle Name:
Last Name:EISENHAUER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DARLA
Other - Middle Name:
Other - Last Name:EISENHAUER-SPIRES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1500 S 48TH ST
Mailing Address - Street 2:SUITE 508
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-1276
Mailing Address - Country:US
Mailing Address - Phone:402-483-2886
Mailing Address - Fax:402-489-9684
Practice Address - Street 1:1500 S 48TH ST
Practice Address - Street 2:SUITE 508
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-1276
Practice Address - Country:US
Practice Address - Phone:402-483-2886
Practice Address - Fax:402-489-9684
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE24435207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
COI53856Medicare UPIN
COC805562Medicare PIN