Provider Demographics
NPI:1750617510
Name:GRESS, DARLA JOAN (RN)
Entity type:Individual
Prefix:MRS
First Name:DARLA
Middle Name:JOAN
Last Name:GRESS
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 1:701 FREMONT DR
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-4699
Mailing Address - Country:US
Mailing Address - Phone:707-449-4096
Mailing Address - Fax:
Practice Address - Street 1:701 FREMONT DR
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-4699
Practice Address - Country:US
Practice Address - Phone:707-449-4096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-28
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO120778163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care