Provider Demographics
NPI:1538244603
Name:DRUMMOND, DARCY LYNN (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:DARCY
Middle Name:LYNN
Last Name:DRUMMOND
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 ALLEN ST
Mailing Address - Street 2:
Mailing Address - City:MASSENA
Mailing Address - State:NY
Mailing Address - Zip Code:13662-1803
Mailing Address - Country:US
Mailing Address - Phone:315-769-9479
Mailing Address - Fax:
Practice Address - Street 1:267 ANDREWS ST
Practice Address - Street 2:
Practice Address - City:MASSENA
Practice Address - State:NY
Practice Address - Zip Code:13662-3401
Practice Address - Country:US
Practice Address - Phone:315-764-0221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332740363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01221452Medicaid
NYP42125Medicare UPIN
NY01221452Medicaid