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General NPI Number Information
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NPI Number | 1053133215
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Entity Type | Individual
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Provider Name | MONICA DURBIN
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Gender | Female
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Dates
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Enumeration Date | 10/29/2024
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 1232 BRANSON HILLS PKWY STE 203
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City | BRANSON
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State | MO
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Zip | 65616-4188
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Country | US
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Telephone | 417-281-1600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 270096
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City | SAINT LOUIS
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State | MO
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Zip | 63127-0096
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 2024003602
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License Number State | MO
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