MRS. TRACI DENISE DARNELL (NPI# 1336128883) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1336128883 |
Entity Type | Individual |
Full Name | MRS. TRACI DENISE DARNELL |
Other Name | MS. TRACI DENISE PHELPS |
Credential | PA C |
Practice Address |
497 W Lott St Buffalo WY 82834-1609 |
Mailing Address |
497 West Lott Buffalo WY 82834-1609 |
Practice Telephone | 3076842228 |
Practice Fax Number | 3076842177 |
Mailing Telephone | 3076842228 |
Mailing Fax Number | 3076842177 |
Enumeration Date | 2006-01-12 |
Last Update Date | 2007-08-01 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
280 | WY | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WY | BLUE CROSS | 313751 | 01 |
WY | 11811730 | 05 |
Street Address |
497 W LOTT ST |
City | BUFFALO |
State | WY |
Zip Code | 82834-1609 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164427274 | Jeffery W Edstrom | Nurse Anesthetist, Certified Registered | 497 W Lott St, Buffalo, WY 82834-1658 | 2005-06-15 |
1700487865 | Savanah K Jackson | Dietitian, Registered | 497 W Lott St, Buffalo, WY 82834-1658 | 2020-11-05 |
1083044630 | Chelsea Puente | Physician Assistant | 497 W Lott St, Buffalo, WY 82834-1658 | 2013-11-18 |
1629364377 | Lisa Marie Mullen | Family Medicine | 497 W Lott St, Buffalo, WY 82834-1658 | 2011-06-21 |
1336229624 | Jennifer Ann Rice | Family Medicine | 497 W Lott St, Buffalo, WY 82834-1658 | 2006-10-17 |
1346228483 | Lawrence Edward Kirven | Family Medicine | 497 W Lott St, Buffalo, WY 82834-1609 | 2006-01-09 |
1316925456 | Aubrey Dozier Tabb | Family Medicine | 497 W Lott St, Buffalo, WY 82834-1609 | 2006-01-09 |
1306824446 | Grace Marie Gosar | Family Medicine | 497 W Lott St, Buffalo, WY 82834-1609 | 2006-01-09 |
1023096153 | Hermilo Gonzalez Jr. | Family Medicine | 497 W Lott St, Buffalo, WY 82834-1609 | 2006-01-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083993216 | Matthew Rick Raney | Dentist | 1001 Eagle View Drive, Buffalo, WY 82834 | 2011-08-05 |
1083881262 | Sandra K Ham | Nurse Practitioner | 107 W Hesse, Buffalo, WY 82834 | 2008-05-15 |
1366502726 | Cotant Family Dentistry, P.C. | Dental Hygienist | 112 High Street, Buffalo, WY 82834 | 2006-12-08 |
1487755823 | Jeanne Louise Peterson | Midwife | 30 Luna, Buffalo, SC 82834 | 2006-09-26 |
1902873193 | James Loren Johnson Jr. | Chiropractor | 963 Fort St, 4, Buffalo, WY 82834 | 2006-03-07 |
1043854888 | Wayne Kenneth Mcpherson Jr. | Marriage & Family Therapist | 512 W. Lott, Buffalo, WY 82834-1336 | 2019-11-05 |
1194248625 | Thales Christian Haskell | Dentist | 1001 Eagle View Dr, Buffalo, WY 82834-1417 | 2017-07-17 |
1528094158 | James Joseph Shubert | Dentist | 1001 Eagle View Dr, Buffalo, WY 82834-1422 | 2006-06-24 |
1457631558 | Eagle Summit Dental Clinic, Inc | Dentist | 1001 Eagle View Dr, Buffalo, WY 82834-1422 | 2011-08-19 |
1366719718 | Bidonde Family Practice, LLC | Nurse Practitioner | 107 W Hesse St, Buffalo, WY 82834-1501 | 2011-11-29 |
Find all providers in zip 82834 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407323546 | Lauren Samantha Wiatrowski | Physician Assistant | 2475 Harlem Rd # 4558, Buffalo, NY 14225-4558 | 2018-10-26 |
1407238744 | Nicole J Jurek | Physician Assistant | 462 Grider St Ste 116, Buffalo, NY 14215-3021 | 2015-06-23 |
1912399114 | Arian Pllana | Physician Assistant | 47 Vermont St, Buffalo, NY 14213-2427 | 2015-02-24 |
1386032928 | Karyanne Cox | Physician Assistant | 100 E Tupper St, Buffalo, NY 14203-1315 | 2015-01-06 |
1255516324 | Harding County Healthcare LLC | Physician Assistant | 209 Ramsland Street, Buffalo, SD 57720-0182 | 2008-01-08 |
1164594099 | Urban Family Practice PC | Physician Assistant | 564 Niagara Street, Buffalo, NY 14201 | 2006-11-15 |
1760567127 | Suzanne Moscati | Physician Assistant | 95 Franklin St, Buffalo, NY 14202-3925 | 2006-10-26 |
1326089087 | Sharon Ruth Wittman-klein | Physician Assistant | 22 Cazenovia St, Buffalo, NY 14220-1706 | 2006-06-10 |
1386681211 | David Michael Dapolito | Physician Assistant | 200 International Dr, Buffalo, NY 14221-8217 | 2006-05-31 |
1801862115 | Patricia Gilbert | Physician Assistant | 209 Ramsland St., Buffalo, SD 57720-0182 | 2006-02-27 |
Find all providers in BUFFALO |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.