Healthcare Provider Details
I. General information
NPI: 1194506899
Provider Name (Legal Business Name): DARBY SCHMIDT LIPATOV APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/09/2023
Last Update Date: 08/30/2024
Certification Date: 08/30/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
402 E 2ND ST
DULUTH MN
55805-1906
US
IV. Provider business mailing address
400 E 3RD ST
DULUTH MN
55805-1951
US
V. Phone/Fax
- Phone: 218-786-3443
- Fax:
- Phone: 218-786-8364
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 10638 |
| License Number State | MN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: