Provider Demographics
NPI:1720960727
Name:PENSON, DARREN
Entity type:Individual
Prefix:MR
First Name:DARREN
Middle Name:
Last Name:PENSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44956 PAINE DR
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-2557
Mailing Address - Country:US
Mailing Address - Phone:248-513-9634
Mailing Address - Fax:
Practice Address - Street 1:44956 PAINE DR
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-2557
Practice Address - Country:US
Practice Address - Phone:248-513-9634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide