Healthcare Provider Details

I. General information

NPI: 1225099336
Provider Name (Legal Business Name): DENISE HELMINE DUREN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3617 S PACIFIC HWY
MEDFORD OR
97501-8957
US

IV. Provider business mailing address

2939 WOODLAND PARK RD
GRANTS PASS OR
97527-7116
US

V. Phone/Fax

Practice location:
  • Phone: 541-535-6239
  • Fax: 541-535-4377
Mailing address:
  • Phone: 541-476-5536
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number087006741N1 FNP-PP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: