Healthcare Provider Details

I. General information

NPI: 1831449826
Provider Name (Legal Business Name): MICHELE MAIN DURLAND FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2012
Last Update Date: 12/20/2023
Certification Date: 12/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 LEW DEWITT BLVD STE B
WAYNESBORO VA
22980-1663
US

IV. Provider business mailing address

PO BOX 388
FISHERSVILLE VA
22939-0388
US

V. Phone/Fax

Practice location:
  • Phone: 540-245-7950
  • Fax: 540-245-7951
Mailing address:
  • Phone: 540-245-7950
  • Fax: 540-245-7951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR185801
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024172703
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: