Healthcare Provider Details

I. General information

NPI: 1447900261
Provider Name (Legal Business Name): DARCY N ROBERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2022
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 44TH AVE N
MYRTLE BEACH SC
29577-5447
US

IV. Provider business mailing address

607 ANNE ST
NORTH MYRTLE BEACH SC
29582-3366
US

V. Phone/Fax

Practice location:
  • Phone: 843-449-3161
  • Fax:
Mailing address:
  • Phone: 843-503-4357
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: