Healthcare Provider Details

I. General information

NPI: 1639890379
Provider Name (Legal Business Name): KYLE ANTHONY DURRANT DNP, FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2022
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17500 SE 392ND ST
AUBURN WA
98092-9705
US

IV. Provider business mailing address

PO BOX 222
SOUTH PRAIRIE WA
98385-0222
US

V. Phone/Fax

Practice location:
  • Phone: 253-939-6648
  • Fax: 253-735-6705
Mailing address:
  • Phone: 360-550-0296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number350570
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP70019905
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95268322
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN61089850
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number763472
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: