Provider Demographics
NPI:1487010807
Name:PFOFF, DARBY MARIE (FNP-C)
Entity Type:Individual
Prefix:
First Name:DARBY
Middle Name:MARIE
Last Name:PFOFF
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:DARBY
Other - Middle Name:MARIE
Other - Last Name:WICKLINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:101 W UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61820-3909
Mailing Address - Country:US
Mailing Address - Phone:217-366-1304
Mailing Address - Fax:
Practice Address - Street 1:101 W UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820-3909
Practice Address - Country:US
Practice Address - Phone:217-366-1304
Practice Address - Fax:217-366-7427
Is Sole Proprietor?:No
Enumeration Date:2016-01-14
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28206387A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily