Provider Demographics
NPI:1194493957
Name:DARWIN, AMY KRISTINE (FNP-C)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:KRISTINE
Last Name:DARWIN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 2ND ST W
Mailing Address - Street 2:
Mailing Address - City:ANDALUSIA
Mailing Address - State:IL
Mailing Address - Zip Code:61232-9223
Mailing Address - Country:US
Mailing Address - Phone:309-373-3891
Mailing Address - Fax:
Practice Address - Street 1:600 N COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:GENESEO
Practice Address - State:IL
Practice Address - Zip Code:61254-1091
Practice Address - Country:US
Practice Address - Phone:309-944-6431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-05
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA165183363LF0000X
IA134329163W00000X
IL041419166163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse