Provider Demographics
NPI:1972031128
Name:DARVILLE, KRISTINA KALLE (ARNP)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:KALLE
Last Name:DARVILLE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:
Other - Last Name:WHISENANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:501 6TH AVE S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4634
Mailing Address - Country:US
Mailing Address - Phone:727-767-4343
Mailing Address - Fax:727-767-8526
Practice Address - Street 1:501 6TH AVE S DEPT
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4634
Practice Address - Country:US
Practice Address - Phone:727-767-4343
Practice Address - Fax:727-767-8526
Is Sole Proprietor?:No
Enumeration Date:2017-06-01
Last Update Date:2017-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9324751363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP9324751OtherSTATE MEDICAL LICENSE