Healthcare Provider Details

I. General information

NPI: 1154286573
Provider Name (Legal Business Name): DARLA SMALL
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 HIGHWAY 6 W
IOWA CITY IA
52246-2209
US

IV. Provider business mailing address

104 RICHLAND AVE
URBANA IA
52345-9021
US

V. Phone/Fax

Practice location:
  • Phone: 319-338-0581
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number149735
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: