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General NPI Number Information
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NPI Number | 1932966934
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Entity Type | Individual
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Provider Name | COREY DARVILL
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Gender | Male
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Dates
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Enumeration Date | 03/05/2024
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Last Update Date | 03/05/2024
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Provider Practice Location Address
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Address Line | 1000 OCHSNER BLVD
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City | COVINGTON
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State | LA
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Zip | 70433-8107
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Country | US
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Telephone | 985-875-2828
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Fax |
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Provider Business Mailing Address
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Address Line | 1053 E CREEK CT
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City | COVINGTON
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State | LA
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Zip | 70435-7304
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Country | US
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Telephone | 225-333-2142
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 202100
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License Number State | LA
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