Darius, Kettly

Darius, Kettly is an individual health care provider with primary practice located at 13000 Bruce B Downs Blvd , Tampa FL 33612-4745. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Darius, Kettly can be contacted via phone (813) 972-2000.

Contact Information

Primary practice address
13000 Bruce B Downs Blvd Tampa FL 33612-4745
Phone: (813) 972-2000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 3147832 Florida

Profile Details

NPI number 1073589735
LBN Legal business name Darius, Kettly
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 23rd, 2006
Last updated Apr 18th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073589735 NPPES
Florida MEDICAID 305584100

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