Provider Demographics
NPI:1033664644
Name:RILEY, DARBY LYNN (MPA)
Entity Type:Individual
Prefix:
First Name:DARBY
Middle Name:LYNN
Last Name:RILEY
Suffix:
Gender:F
Credentials:MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8490 COLLEGE BLVD
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2123
Mailing Address - Country:US
Mailing Address - Phone:913-722-5551
Mailing Address - Fax:
Practice Address - Street 1:8490 COLLEGE BLVD
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2123
Practice Address - Country:US
Practice Address - Phone:913-722-5551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant