Healthcare Provider Details

I. General information

NPI: 1124312582
Provider Name (Legal Business Name): PRISCILLA LYNN DARWIN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PRISCILLA LYNN MAYA FNP

II. Dates (important events)

Enumeration Date: 06/02/2011
Last Update Date: 01/28/2021
Certification Date: 01/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4110 BRIARGATE PKWY STE 405
COLORADO SPRINGS CO
80920-7838
US

IV. Provider business mailing address

7703 FLOYD CURL DR
SAN ANTONIO TX
78229-3901
US

V. Phone/Fax

Practice location:
  • Phone: 719-365-7300
  • Fax:
Mailing address:
  • Phone: 210-450-9700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number729330
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number729330
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberC-APN.0001801-C-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: