Doctor Name: | MRS. SANDRA C DURRETT |
NPI Number: | 1033195953 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CFNP |
License Number: | R803937 |
Business Practice Address: | 300 Oxford Road New Albany, MS - 38652 |
Business Phone Number: | 6625348166 |
Business Fax Number: | 6625348132 |
Mailing Address: | 300 Oxford Road, NEW ALBANY |
State: | MS |
Postal Code: | 38652 |
Phone Number: | 6625348166 |
Fax Number: | 6625348132 |
NPI Enumeration Date: | 12/22/2005 |
NPI Last Update Date: | 03/08/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R803937 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |