Healthcare Provider Details

I. General information

NPI: 1316244528
Provider Name (Legal Business Name): KRISTY DARNELL RN,MSN, FNP-BC, CNRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2011
Last Update Date: 02/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E 89TH AVE
MERRILLVILLE IN
46410-7318
US

IV. Provider business mailing address

1108 COUNTRY CLUB DR
CROWN POINT IN
46307-9344
US

V. Phone/Fax

Practice location:
  • Phone: 218-738-4930
  • Fax: 219-738-4931
Mailing address:
  • Phone: 219-738-4930
  • Fax: 219-738-4931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0800X
TaxonomyNeuroscience Registered Nurse
License Number28085181A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code163WN0800X
TaxonomyNeuroscience Registered Nurse
License Number71003518A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: