Healthcare Provider Details

I. General information

NPI: 1609819747
Provider Name (Legal Business Name): BENJAMIN MONROE DURR NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 09/11/2020
Certification Date: 09/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9900 BREN RD E
MINNETONKA MN
55343-9664
US

IV. Provider business mailing address

9055 NINA RD
CONROE TX
77304-3727
US

V. Phone/Fax

Practice location:
  • Phone: 832-326-2327
  • Fax:
Mailing address:
  • Phone: 832-326-2327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number594436
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP110439
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: