Provider Demographics
NPI:1083376453
Name:DARBY-BROWN, KRISTIN NICHOLE
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:NICHOLE
Last Name:DARBY-BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:NICHOLE
Other - Last Name:DARBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12780 WATERFORD LAKES PKWY STE 120
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-4501
Mailing Address - Country:US
Mailing Address - Phone:321-841-9514
Mailing Address - Fax:407-636-7864
Practice Address - Street 1:12780 WATERFORD LAKES PKWY STE 120
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-4501
Practice Address - Country:US
Practice Address - Phone:321-841-9514
Practice Address - Fax:407-636-7864
Is Sole Proprietor?:No
Enumeration Date:2021-10-12
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11012523363LF0000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily