Provider Demographics
NPI:1104559798
Name:DARR, RONA SUE (LPN)
Entity type:Individual
Prefix:
First Name:RONA
Middle Name:SUE
Last Name:DARR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:RONA
Other - Middle Name:
Other - Last Name:DARR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:401 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:DOWAGIAC
Mailing Address - State:MI
Mailing Address - Zip Code:49047-2028
Mailing Address - Country:US
Mailing Address - Phone:269-414-1842
Mailing Address - Fax:
Practice Address - Street 1:960 M
Practice Address - Street 2:
Practice Address - City:CASSOPOLIS
Practice Address - State:MI
Practice Address - Zip Code:49031
Practice Address - Country:US
Practice Address - Phone:269-445-2451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-01
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703052771164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse