Healthcare Provider Details

I. General information

NPI: 1083499412
Provider Name (Legal Business Name): DARLENE BURCH PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2023
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6428 BEACH BLVD
JACKSONVILLE FL
32216-2813
US

IV. Provider business mailing address

1542 KINGSLEY AVE STE 136-137
ORANGE PARK FL
32073-4586
US

V. Phone/Fax

Practice location:
  • Phone: 904-475-2039
  • Fax:
Mailing address:
  • Phone: 904-458-7780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11028174
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: