Provider Demographics
NPI:1548862584
Name:STITT, DARLA J
Entity type:Individual
Prefix:MRS
First Name:DARLA
Middle Name:J
Last Name:STITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5949 CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:KINGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44048-9792
Mailing Address - Country:US
Mailing Address - Phone:440-415-5414
Mailing Address - Fax:
Practice Address - Street 1:5949 CEMETERY RD
Practice Address - Street 2:
Practice Address - City:KINGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44048-9792
Practice Address - Country:US
Practice Address - Phone:440-415-5414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2588418Medicaid