Healthcare Provider Details

I. General information

NPI: 1265015770
Provider Name (Legal Business Name): SABLE DARLING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2021
Last Update Date: 01/13/2026
Certification Date: 01/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 ELLSWORTH AFB
ELLSWORTH AFB SD
57706
US

IV. Provider business mailing address

916 DEADWOOD LOOP
ELLSWORTH AFB SD
57706-4204
US

V. Phone/Fax

Practice location:
  • Phone: 605-974-5687
  • Fax:
Mailing address:
  • Phone: 605-974-5687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number57925
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: