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General NPI Number Information
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NPI Number | 1740701804
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Entity Type | Individual
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Provider Name | KELSY DARBY FNP
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Gender | Female
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Dates
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Enumeration Date | 06/29/2017
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Last Update Date | 04/05/2018
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Provider Practice Location Address
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Address Line | 6301 E 125TH ST
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City | GRANDVIEW
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State | MO
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Zip | 64030-1884
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Country | US
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Telephone | 816-765-7714
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Fax |
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Provider Business Mailing Address
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Address Line | 36123 SCHOOLCRAFT RD
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City | LIVONIA
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State | MI
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Zip | 48150-1216
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Country | US
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Telephone | 913-660-1616
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2017019835
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License Number State | MO
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