Provider Demographics
NPI:1184430936
Name:FORSON, DARLENE ABENAA
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:ABENAA
Last Name:FORSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14676 MARIGOLD DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-0722
Mailing Address - Country:US
Mailing Address - Phone:801-836-2476
Mailing Address - Fax:
Practice Address - Street 1:14676 MARIGOLD DR
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-0722
Practice Address - Country:US
Practice Address - Phone:801-836-2476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX816895163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse