Provider Demographics
NPI:1922399815
Name:DARSON, WANDA K (CRNP)
Entity type:Individual
Prefix:
First Name:WANDA
Middle Name:K
Last Name:DARSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2616 JORDAN LANE NW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35816-1014
Mailing Address - Country:US
Mailing Address - Phone:256-851-8433
Mailing Address - Fax:256-851-6080
Practice Address - Street 1:2616 JORDAN LANE NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35816-1014
Practice Address - Country:US
Practice Address - Phone:256-851-8433
Practice Address - Fax:256-851-6080
Is Sole Proprietor?:No
Enumeration Date:2011-04-26
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1121980363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1121980OtherALABAMA BOARD OF NURSING STATE LICENSE NUMBER