Healthcare Provider Details

I. General information

NPI: 1275777070
Provider Name (Legal Business Name): REBECCA J DARNER ST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2009
Last Update Date: 04/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 E APPLE ST SUITE 6252
DAYTON OH
45409-2939
US

IV. Provider business mailing address

30 E APPLE ST SUITE 6252
DAYTON OH
45409-2939
US

V. Phone/Fax

Practice location:
  • Phone: 937-208-6060
  • Fax: 937-208-6061
Mailing address:
  • Phone: 937-208-6060
  • Fax: 937-208-6061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: