Healthcare Provider Details

I. General information

NPI: 1699922914
Provider Name (Legal Business Name): LORI A DARRAH CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2008
Last Update Date: 06/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 S STANFIELD RD
TROY OH
45373
US

IV. Provider business mailing address

7835 PARAGON RD
DAYTON OH
45459-4021
US

V. Phone/Fax

Practice location:
  • Phone: 937-339-8380
  • Fax: 937-335-4096
Mailing address:
  • Phone: 937-436-4146
  • Fax: 937-434-1266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.022760
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: