Healthcare Provider Details

I. General information

NPI: 1982354528
Provider Name (Legal Business Name): KAYLA REBECCA DARRIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2022
Last Update Date: 05/11/2025
Certification Date: 05/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 IRVING ST NW
WASHINGTON DC
20010-3017
US

IV. Provider business mailing address

110 IRVING ST NW
WASHINGTON DC
20010-3017
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-2424
  • Fax: 202-877-7633
Mailing address:
  • Phone: 202-877-2424
  • Fax: 202-877-7633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD0103083
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: