Healthcare Provider Details

I. General information

NPI: 1730130543
Provider Name (Legal Business Name): DARRELL STEVEN KIRBY RN
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7171 BOWLING DR SOUTH CITY STE 300
SACRAMENTO CA
95823
US

IV. Provider business mailing address

8476 DARTFORD DR
SACRAMENTO CA
95823
US

V. Phone/Fax

Practice location:
  • Phone: 916-682-4801
  • Fax:
Mailing address:
  • Phone: 916-682-4801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number388488
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: