Healthcare Provider Details

I. General information

NPI: 1346928348
Provider Name (Legal Business Name): ALEXANDRIA DURCZYNSKI PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2023
Last Update Date: 07/10/2023
Certification Date: 07/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 NAVARRE AVE
OREGON OH
43616-3207
US

IV. Provider business mailing address

412 S BERLIN AVE
OREGON OH
43616-2806
US

V. Phone/Fax

Practice location:
  • Phone: 419-696-8800
  • Fax:
Mailing address:
  • Phone: 419-705-5853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0034342
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: