Doctor Name: | WAYNE E DARSOW |
NPI Number: | 1457412413 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | ARNP |
License Number: | 45580 |
Business Practice Address: | 600 Caisson Hill Road Fort Riley, KS - 664425037 |
Business Phone Number: | 7852397155 |
Business Fax Number: | 7852397364 |
Mailing Address: | 600 Caisson Hill Road, FORT RILEY |
State: | KS |
Postal Code: | 664425037 |
Phone Number: | 7852397155 |
Fax Number: | 7852397364 |
NPI Enumeration Date: | 12/13/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 45580 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |