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General NPI Number Information
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NPI Number | 1073233797
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Entity Type | Individual
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Provider Name | KELLEENA SHANNA DURAN MSN, APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/01/2022
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Last Update Date | 06/07/2025
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Provider Practice Location Address
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Address Line | 404 S EASTERN AVE
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City | ELK CITY
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State | OK
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Zip | 73644-9608
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Country | US
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Telephone | 580-303-5890
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Fax | 580-303-5891
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Provider Business Mailing Address
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Address Line | 404 S EASTERN AVE
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City | ELK CITY
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State | OK
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Zip | 73644-9608
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Country | US
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Telephone | 580-303-5890
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Fax | 580-303-5891
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1097082
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 210845
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License Number State | OK
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