Healthcare Provider Details

I. General information

NPI: 1376671859
Provider Name (Legal Business Name): MARIA D DURAND APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 07/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 YORK ST
NEW HAVEN CT
06510
US

IV. Provider business mailing address

34 KINGSWOOD DR
SOUTHINGTON CT
06489-4113
US

V. Phone/Fax

Practice location:
  • Phone: 203-688-1616
  • Fax:
Mailing address:
  • Phone: 860-276-7600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number002538
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code364SP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
License Number2538
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: