Doctor Name: | DARREN JAMES DAMIANI |
NPI Number: | 1740525161 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | R-141361-2 |
Business Practice Address: | 3278 Mitchell Blvd Moody Afb, GA - 316991500 |
Business Phone Number: | 2292574775 |
Business Fax Number: | |
Mailing Address: | 3278 Mitchell Blvd, MOODY AFB |
State: | GA |
Postal Code: | 316991500 |
Phone Number: | 2292574775 |
Fax Number: | |
NPI Enumeration Date: | 12/11/2012 |
NPI Last Update Date: | 10/09/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R-141361-2 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |