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General NPI Number Information
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NPI Number | 1447453881
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Entity Type | Individual
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Provider Name | LILIANA PETRUTA DURKEE PMHNP
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Gender | Female
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Dates
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Enumeration Date | 06/05/2007
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 149 S RIDGEWOOD AVE
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-4386
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Country | US
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Telephone | 800-614-4124
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Fax |
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Provider Business Mailing Address
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Address Line | 84 BAINBRIDGE LN
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City | PALM COAST
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State | FL
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Zip | 32137-8856
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Country | US
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Telephone | 386-793-6390
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11009387
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License Number State | FL
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