Basic Information
| Provider Information | |||||||||
| NPI: | 1952429136 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DARRAH | ||||||||
| FirstName: | LARRY | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 222 N 5TH ST | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | MARTINS FERRY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 439351582 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7406336480 | ||||||||
| FaxNumber: | 7406336475 | ||||||||
| Practice Location | |||||||||
| Address1: | 222 N 5TH ST | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | MARTINS FERRY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 439351582 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7406336480 | ||||||||
| FaxNumber: | 7406336475 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | NP07360 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.