Healthcare Provider Details

I. General information

NPI: 1366581241
Provider Name (Legal Business Name): EVELYN NMI DURKEE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21885 DUNHAM RD
CLINTON TWP MI
48036-1030
US

IV. Provider business mailing address

50058 CORBIN CT
CHESTERFIELD MI
48047-1914
US

V. Phone/Fax

Practice location:
  • Phone: 586-469-5200
  • Fax:
Mailing address:
  • Phone: 586-469-6582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number4704102328
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: