Provider Demographics
NPI:1619413960
Name:DARBY, TRENELL (DNP)
Entity Type:Individual
Prefix:DR
First Name:TRENELL
Middle Name:
Last Name:DARBY
Suffix:
Gender:M
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 HOFFMAN ST
Mailing Address - Street 2:STE 150
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-2510
Mailing Address - Country:US
Mailing Address - Phone:608-441-3220
Mailing Address - Fax:
Practice Address - Street 1:1705 HOFFMAN ST
Practice Address - Street 2:STE 150
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-2510
Practice Address - Country:US
Practice Address - Phone:608-441-3220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-10
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7530 - 33363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner