Healthcare Provider Details

I. General information

NPI: 1275909061
Provider Name (Legal Business Name): RACHEL DURRANT CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2015
Last Update Date: 08/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 S LUDLOW ST
DAYTON OH
45402-2610
US

IV. Provider business mailing address

106 SANDELWOOD ST
SPRINGBORO OH
45066-5235
US

V. Phone/Fax

Practice location:
  • Phone: 937-734-4141
  • Fax:
Mailing address:
  • Phone: 513-602-3452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA.17848-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: