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General NPI Number Information
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NPI Number | 1598869703
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Entity Type | Individual
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Provider Name | NICOLE ELIZABETH DURNIN R.PH.
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Gender | Female
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Dates
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Enumeration Date | 09/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2018 N. CEDAR STREET SUITE A
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City | HOLT
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State | MI
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Zip | 48842
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Country | US
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Telephone | 517-694-9707
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Fax | 517-694-9713
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Provider Business Mailing Address
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Address Line | 2126 TECUMSEH RIVER ROAD
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City | LANSING
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State | MI
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Zip | 48906
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Country | US
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Telephone | 517-896-1665
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302029280
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License Number State | MI
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