Healthcare Provider Details

I. General information

NPI: 1205862521
Provider Name (Legal Business Name): DARLENE MARKS F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DARLENE MARKS FNP

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 05/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 FIFTH RD
SUMMERTOWN TN
38483-8047
US

IV. Provider business mailing address

166 FIFTH RD
SUMMERTOWN TN
38483-8047
US

V. Phone/Fax

Practice location:
  • Phone: 808-557-8532
  • Fax:
Mailing address:
  • Phone: 808-557-8532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN40485
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number989
License Number StateAK
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number17658
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0000082
License Number StateCO
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number961
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: