Healthcare Provider Details

I. General information

NPI: 1720059058
Provider Name (Legal Business Name): AUDREY K DARVILLE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 04/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 F COLLEGE OF NURSING UNIVERSITY OF KENTUCKY
LEXINGTON KY
40536-0232
US

IV. Provider business mailing address

450 F COLLEGE OF NURSING UNIVERSITY OF KENTUCKY
LEXINGTON KY
40536-0232
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-4222
  • Fax: 859-323-1200
Mailing address:
  • Phone: 859-323-4222
  • Fax: 859-323-1200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3002753
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: