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Individual

DARLA DANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
710 KENMOOR AVE SE STE 100, GRAND RAPIDS, MI 49546-2379
(419) 973-9484
Mailing address
710 KENMOOR AVE SE STE 100, GRAND RAPIDS, MI 49546-2379
(616) 421-9387

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0030094
OH
363L00000X
Nurse Practitioner
Primary
290478
AZ
363L00000X
Nurse Practitioner
4704356150
MI

Other

Enumeration date
10/08/2021
Last updated
09/24/2024
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