Healthcare Provider Details

I. General information

NPI: 1811630775
Provider Name (Legal Business Name): KOLBY HERRON FINKE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2022
Last Update Date: 10/29/2026
Certification Date: 10/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6420 3RD ST STE 104
ROCKLEDGE FL
32955-5788
US

IV. Provider business mailing address

6420 3RD ST STE 104
ROCKLEDGE FL
32955-5788
US

V. Phone/Fax

Practice location:
  • Phone: 321-757-9711
  • Fax: 321-253-1675
Mailing address:
  • Phone: 321-757-9711
  • Fax: 321-253-1675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11039134
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: