Basic Information
Provider Information
NPI: 1235862962
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FOOR
FirstName: DARBY
MiddleName: BRIDGET
NamePrefix:  
NameSuffix:  
Credential: ARNP, RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9977 CAPPERTON DR
Address2:  
City: OAKTON
State: VA
PostalCode: 221242913
CountryCode: US
TelephoneNumber: 4122665942
FaxNumber:  
Practice Location
Address1: 3801 KERN WAY
Address2:  
City: YAKIMA
State: WA
PostalCode: 989026340
CountryCode: US
TelephoneNumber: 5095743200
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/09/2022
LastUpdateDate: 07/09/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/04/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WP0200XRN61327294WAN Nursing Service ProvidersRegistered NursePediatrics
363LP0200XAP61331931WAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics

No ID Information.


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