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General NPI Number Information
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NPI Number | 1205556479
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Entity Type | Individual
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Provider Name | AMY MICHELLE DURHAM APRN
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Gender | Female
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Dates
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Enumeration Date | 08/29/2022
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Last Update Date | 08/29/2022
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Provider Practice Location Address
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Address Line | 107 MERIDIAN WAY
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City | RICHMOND
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State | KY
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Zip | 40475-2878
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Country | US
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Telephone | 606-682-5505
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 654
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City | EAST BERNSTADT
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State | KY
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Zip | 40729-0654
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3016905
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License Number State | KY
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