Healthcare Provider Details

I. General information

NPI: 1033374046
Provider Name (Legal Business Name): COLLEEN M DARNELL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2008
Last Update Date: 10/01/2020
Certification Date: 10/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL VILLAGE DR
EDGEWOOD KY
41017-3403
US

IV. Provider business mailing address

PO BOX 636324
CINCINNATI OH
45263-6324
US

V. Phone/Fax

Practice location:
  • Phone: 859-301-4000
  • Fax: 859-301-4001
Mailing address:
  • Phone: 859-301-4000
  • Fax: 859-301-4001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number49461
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number35.124371
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: