Healthcare Provider Details

I. General information

NPI: 1225719396
Provider Name (Legal Business Name): KIM MCQUEEN DURRANT MSN PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2023
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9292 SHOAL CREEK DR
TALLAHASSEE FL
32312-4277
US

IV. Provider business mailing address

9292 SHOAL CREEK DR
TALLAHASSEE FL
32312-4277
US

V. Phone/Fax

Practice location:
  • Phone: 850-966-2145
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11027574
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: