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General NPI Number Information
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NPI Number | 1891485801
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Entity Type | Individual
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Provider Name | MAMMIETTA O DARKO FNP
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Gender | Female
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Dates
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Enumeration Date | 05/11/2023
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 4532 PLANK RD
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City | FREDERICKSBURG
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State | VA
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Zip | 22407-0139
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Country | US
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Telephone | 540-252-1840
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Fax |
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Provider Business Mailing Address
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Address Line | 9315 BLUE PINE LN
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City | FREDERICKSBURG
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State | VA
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Zip | 22407-7392
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Country | US
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Telephone | 805-990-3568
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.0033484
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License Number State | OH
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