Provider Demographics
NPI:1740839232
Name:ATKINS, DARLETTA RENEE (ASSISTANT)
Entity type:Individual
Prefix:
First Name:DARLETTA
Middle Name:RENEE
Last Name:ATKINS
Suffix:
Gender:F
Credentials:ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45363 CEDAR AVE APT 9
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-1905
Mailing Address - Country:US
Mailing Address - Phone:747-214-5247
Mailing Address - Fax:
Practice Address - Street 1:45363 CEDAR AVE APT 9
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-1905
Practice Address - Country:US
Practice Address - Phone:747-214-5247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-06
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty