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General NPI Number Information
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NPI Number | 1134266638
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Entity Type | Individual
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Provider Name | TERRI SUE DURAN FNP
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Gender | Female
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 03/11/2024
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Provider Practice Location Address
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Address Line | 6105 WILSON AVE SW STE 202
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City | WYOMING
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State | MI
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Zip | 49418-9714
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Country | US
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Telephone | 616-486-5299
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Fax | 616-486-5056
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Provider Business Mailing Address
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Address Line | 100 MICHIGAN ST NE # MC845
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-2560
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN7374
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License Number State | TN
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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 | 4704202288
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License Number State | MI
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