Provider Demographics
NPI:1497766125
Name:DARBY, WENDY A (CRNP)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:A
Last Name:DARBY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 WEST COLLEGE ST
Mailing Address - Street 2:INFANTS AND CHILDRENS CLINIC PC
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630
Mailing Address - Country:US
Mailing Address - Phone:256-764-9522
Mailing Address - Fax:256-764-1139
Practice Address - Street 1:421 WEST COLLEGE ST
Practice Address - Street 2:INFANTS AND CHILDRENS CLINIC PC
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630
Practice Address - Country:US
Practice Address - Phone:256-764-9522
Practice Address - Fax:256-764-1139
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1048599363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000032101Medicaid
AL51032101OtherBC
AL51032101OtherBC