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Individual

DARRELL DEMARTINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP-BC, RN, EMT-P

Contact information

Practice address
12303 DEPAUL DRIVE, BRIDGETON, MO 63044
(517) 242-1705
Mailing address
206 REDMOND PINES DR, WENTZVILLE, MO 63385-4304

Taxonomy

Speciality
Code
Description
License number
State
146L00000X
Paramedic
3201009993
MI
146L00000X
Paramedic
P-20168
MO
163W00000X
Registered Nurse
4704274228
MI
163WE0003X
Emergency Registered Nurse
2016044503
MO
363LA2100X
Acute Care Nurse Practitioner
Primary
2017002497
MO
363LF0000X
Family Nurse Practitioner
2017002498
MO
363LF0000X
Family Nurse Practitioner
4704274228
MI

Other

Enumeration date
02/02/2015
Last updated
02/13/2018
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