Mikayla Darrah
Individual provider Active NPI Case Management Registered Nurse · Fort Drum, NY
NPI 1114739349 · NPPES record last updated Jan 24, 2025
Key facts
- NPI
- 1114739349
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Management Registered Nurse 163WC0400X
- License
- 707684-01 (NY)
- Practice address
- 11050 Mt Belvedere Blvd
Fort Drum, NY 13602-2603 - Phone
- (315) 772-0215
- NPI assigned
- Jan 24, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 707684-01 | NY | MD | Case Management Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Registered Nurse | 163WC0400X | 707684-01 | NY | Yes |
Addresses
Primary practice location
11050 Mt Belvedere Blvd
Fort Drum, NY 13602-2603
Mailing address
11050 Mt Belvedere Blvd
Fort Drum, NY 13602-2603
Other providers in Fort Drum, NY
- Travis Dean Cudlin
- Peter Leo Cuff
- Maureen Daley
- Phillip Dandridge
- Colleen A Daniels
- Charles Darsan
- Linda Mae Davis
- Mary M. Davis
- Corey M Day
- Jessica Sara De la Flor
All providers in Fort Drum, NY · Case Management Registered Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.