Provider Demographics
NPI:1124312582
Name:DARWIN, PRISCILLA LYNN (NP)
Entity type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:LYNN
Last Name:DARWIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:PRISCILLA
Other - Middle Name:LYNN
Other - Last Name:MAYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:7703 FLOYD CURL DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3901
Mailing Address - Country:US
Mailing Address - Phone:210-450-9700
Mailing Address - Fax:
Practice Address - Street 1:4110 BRIARGATE PKWY STE 405
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7838
Practice Address - Country:US
Practice Address - Phone:719-365-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-02
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX729330163W00000X, 363LF0000X
COC-APN.0001801-C-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX285721101Medicaid
TX285721103Medicaid
TX850N46OtherBCBS
TX285721104OtherMEDICAID CSHCN
TX285721103Medicaid
TX850N46OtherBCBS