Healthcare Provider Details

I. General information

NPI: 1063331510
Provider Name (Legal Business Name): JODI DURMOWICZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1703 INNOVATION DR
YORK PA
17408-8815
US

IV. Provider business mailing address

1703 INNOVATION DR
YORK PA
17408-8815
US

V. Phone/Fax

Practice location:
  • Phone: 717-815-2548
  • Fax: 717-801-0645
Mailing address:
  • Phone: 717-815-2548
  • Fax: 717-801-0645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License NumberR177873
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: