Healthcare Provider Details

I. General information

NPI: 1063614667
Provider Name (Legal Business Name): DARLA LYNETTE ELSNER R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 GLENDON CT
DUBLIN OH
43016-3249
US

IV. Provider business mailing address

412 N COUNTRY CLUB RD
COLUMBUS IN
47201-9288
US

V. Phone/Fax

Practice location:
  • Phone: 614-792-1085
  • Fax: 888-627-0064
Mailing address:
  • Phone: 812-342-1603
  • Fax: 812-342-2758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number28132401A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: