Provider Demographics
NPI:1871633206
Name:JUMPP, DARLENE HOLSCLAW (RNFA)
Entity type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:HOLSCLAW
Last Name:JUMPP
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:MRS
Other - First Name:DARLENE
Other - Middle Name:HOLSCLAW
Other - Last Name:JUMPP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, BSN,RNFA ,LLC
Mailing Address - Street 1:4303 GREEN PINE CT
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-1530
Mailing Address - Country:US
Mailing Address - Phone:502-459-2319
Mailing Address - Fax:502-459-2319
Practice Address - Street 1:4303 GREEN PINE CT
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-1530
Practice Address - Country:US
Practice Address - Phone:502-459-2319
Practice Address - Fax:502-459-2319
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1030207163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant