Provider Demographics
NPI:1740529452
Name:DARNELL, PAMELA L (FNP-C)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:L
Last Name:DARNELL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3105 MC CLELLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-1640
Mailing Address - Country:US
Mailing Address - Phone:417-347-8400
Mailing Address - Fax:417-347-5818
Practice Address - Street 1:100 MERCY WAY STE 310
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-4524
Practice Address - Country:US
Practice Address - Phone:417-556-8600
Practice Address - Fax:417-556-8602
Is Sole Proprietor?:No
Enumeration Date:2013-02-01
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013001296363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200978560AMedicaid
MOP01165164OtherRAIL ROAD MEDICARE
MO1740529452Medicaid
OK200483590AMedicaid
MO1740529452Medicaid