Healthcare Provider Details

I. General information

NPI: 1588837934
Provider Name (Legal Business Name): MRS. BEVERLY DURAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2008
Last Update Date: 11/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7530 MALVERN DR
NEW ORLEANS LA
70126-2114
US

IV. Provider business mailing address

PO BOX 29974
NEW ORLEANS LA
70189-0974
US

V. Phone/Fax

Practice location:
  • Phone: 504-458-8614
  • Fax: 504-240-2858
Mailing address:
  • Phone: 504-458-8614
  • Fax: 504-240-2858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number35262887K
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: