Healthcare Provider Details

I. General information

NPI: 1265190797
Provider Name (Legal Business Name): MAKAYLA DURRANT APRN, MSN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2021
Last Update Date: 04/02/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 REFUGEE RD STE 100-A
PICKERINGTON OH
43147-9861
US

IV. Provider business mailing address

1025 REFUGEE RD STE 100-A
PICKERINGTON OH
43147-9861
US

V. Phone/Fax

Practice location:
  • Phone: 614-754-5500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0030019
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71012060A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3015946
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.406870
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1158545
License Number StateKY
# 6
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28265784A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: