Durrence, Sandra M

Durrence, Sandra M is an individual health care provider with primary practice located at 1061 Harmon Ave Ste 1003 , Fort Stewart GA 31314-5641. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Durrence, Sandra M can be contacted via phone (912) 435-6633.

Contact Information

Primary practice address
1061 Harmon Ave Ste 1003 Fort Stewart GA 31314-5641
Phone: (912) 435-6633
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X RN077240 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN077240 Georgia

Profile Details

NPI number 1285668186
LBN Legal business name Durrence, Sandra M
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2006
Last updated Jul 9th, 2012 - about 13 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 1285668186 NPPES
Georgia MEDICAID 000680215M

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