Healthcare Provider Details

I. General information

NPI: 1265584411
Provider Name (Legal Business Name): STEPHEN E DURAND APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 04/16/2021
Certification Date: 04/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1575 PINE RIDGE RD SUITE 16
NAPLES FL
34109
US

IV. Provider business mailing address

1575 PINE RIDGE RD SUITE 16
NAPLES FL
34109
US

V. Phone/Fax

Practice location:
  • Phone: 239-494-2346
  • Fax: 239-734-3782
Mailing address:
  • Phone: 239-494-2346
  • Fax: 239-734-3782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP 9214908
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: