Provider Demographics
NPI:1720611643
Name:STROUD, DARLENE F
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:F
Last Name:STROUD
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 1:5823 HADRIAN DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-7143
Mailing Address - Country:US
Mailing Address - Phone:919-641-3339
Mailing Address - Fax:919-477-4282
Practice Address - Street 1:5823 HADRIAN DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-7143
Practice Address - Country:US
Practice Address - Phone:919-641-3339
Practice Address - Fax:919-477-4282
Is Sole Proprietor?:No
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide