Provider Demographics
NPI:1104145630
Name:WELLER, DARCY DENISE (RN)
Entity type:Individual
Prefix:MRS
First Name:DARCY
Middle Name:DENISE
Last Name:WELLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 WEST CENTER STREET
Mailing Address - Street 2:
Mailing Address - City:MONONA
Mailing Address - State:IA
Mailing Address - Zip Code:52159
Mailing Address - Country:US
Mailing Address - Phone:563-539-4885
Mailing Address - Fax:
Practice Address - Street 1:403 W CENTER ST
Practice Address - Street 2:
Practice Address - City:MONONA
Practice Address - State:IA
Practice Address - Zip Code:52159-8225
Practice Address - Country:US
Practice Address - Phone:563-539-4885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA087822163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse