Healthcare Provider Details

I. General information

NPI: 1851812309
Provider Name (Legal Business Name): MARK ALAN DARBY I MSN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

985330 NEBRASKA MEDICAL CTR
OMAHA NE
68198-2702
US

IV. Provider business mailing address

985330 NEBRASKA MEDICAL CTR
OMAHA NE
68198-5330
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-7925
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number38769
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number112235
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: