Provider Demographics
NPI:1396327664
Name:BOOTH, DARLA ANN (CNP)
Entity type:Individual
Prefix:
First Name:DARLA
Middle Name:ANN
Last Name:BOOTH
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:470 TOWNSHIP ROAD 1101
Mailing Address - Street 2:
Mailing Address - City:NOVA
Mailing Address - State:OH
Mailing Address - Zip Code:44859-9737
Mailing Address - Country:US
Mailing Address - Phone:330-705-0330
Mailing Address - Fax:
Practice Address - Street 1:1860 STATE RD STE C
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223-1400
Practice Address - Country:US
Practice Address - Phone:330-940-5770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.026602363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health