Healthcare Provider Details

I. General information

NPI: 1316191646
Provider Name (Legal Business Name): JAMES D DURBIN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2008
Last Update Date: 07/14/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5925 US HIGHWAY 60 W SUITE D
PADUCAH KY
42001
US

IV. Provider business mailing address

2780 - D NEW HOLT RD BOX 239
PADUCAH KY
42001
US

V. Phone/Fax

Practice location:
  • Phone: 270-276-6502
  • Fax: 270-276-6503
Mailing address:
  • Phone: 270-276-6502
  • Fax: 270-276-6503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1100137
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: