Individual
DARLA R THEOBALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1025 MARSH ST, MANKATO, MN 56001-4752
(507) 625-4031
Mailing address
1025 MARSH ST, MANKATO, MN 56001-4752
(507) 625-4031
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1113
MN
363L00000X
Nurse Practitioner
R1159484
MN
Other
Enumeration date
11/29/2005
Last updated
09/18/2020
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