Provider Demographics
NPI:1366065716
Name:DARBY, TABATHA R (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MS
First Name:TABATHA
Middle Name:R
Last Name:DARBY
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 WHISTLE WAY
Mailing Address - Street 2:
Mailing Address - City:PELZER
Mailing Address - State:SC
Mailing Address - Zip Code:29669-1555
Mailing Address - Country:US
Mailing Address - Phone:864-630-4106
Mailing Address - Fax:
Practice Address - Street 1:712 GROVE RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4211
Practice Address - Country:US
Practice Address - Phone:864-313-1602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCF05200432363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily