Provider Demographics
NPI:1720059058
Name:DARVILLE, AUDREY K (APRN)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:K
Last Name:DARVILLE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 F COLLEGE OF NURSING
Mailing Address - Street 2:UNIVERSITY OF KENTUCKY
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0232
Mailing Address - Country:US
Mailing Address - Phone:859-323-4222
Mailing Address - Fax:859-323-1200
Practice Address - Street 1:450 F COLLEGE OF NURSING
Practice Address - Street 2:UNIVERSITY OF KENTUCKY
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0232
Practice Address - Country:US
Practice Address - Phone:859-323-4222
Practice Address - Fax:859-323-1200
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3002753363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000064838OtherANTHEM BC/BS
KY78027539Medicaid
KY000000064838OtherANTHEM BC/BS
0599402Medicare ID - Type Unspecified