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Individual

MRS. LELA KRISTINE DARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
1051 TALBOTTON RD, COLUMBUS, GA 31904-8745
(706) 322-2511
(706) 322-0913
Mailing address
1051 TALBOTTON RD, COLUMBUS, GA 31904-8745
(706) 322-2511
(706) 322-0913

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1-077179
AL
363L00000X
Nurse Practitioner
Primary
RN222649
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
510-70395
BLUE CROSS BLUE SHIELD
AL
Enumeration date
02/24/2009
Last updated
09/07/2012
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