Healthcare Provider Details

I. General information

NPI: 1215506407
Provider Name (Legal Business Name): DARCIE ANN LYNN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2021
Last Update Date: 05/25/2023
Certification Date: 05/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11349 CORTEZ BLVD
BROOKSVILLE FL
34613-5404
US

IV. Provider business mailing address

798. W. CHAMPLAIN LANE
CITRUS SPRINGS FL
34434
US

V. Phone/Fax

Practice location:
  • Phone: 352-616-7600
  • Fax: 352-616-7601
Mailing address:
  • Phone: 813-598-0053
  • Fax: 239-790-2624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11015130
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number9261885
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: