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NPI 1780649632

NPI 1780649632 : PATRICIA DURHAM FNP : LUBBOCK, TX

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General NPI Number Information
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    NPI Number           |    1780649632
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    Entity Type          |    Individual 
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    Provider Name        |    PATRICIA DURHAM FNP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/20/2006
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    Last Update Date     |    08/28/2019
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Provider Practice Location Address
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    Address Line         |    808 JOLIET AVE UNIT 220 
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    City                 |    LUBBOCK
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    State                |    TX
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    Zip                  |    79415-1158
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    Country              |    US
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    Telephone            |    806-761-0566
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    Fax                  |    806-744-7252
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Provider Business Mailing Address
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    Address Line         |    5219 CITY BANK PKWY STE 214 
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    City                 |    LUBBOCK
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    State                |    TX
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    Zip                  |    79407-3537
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    Country              |    US
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    Telephone            |    806-761-0333
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    Fax                  |    806-782-0097
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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       |    525228
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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       |    AP110323
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    License Number State |    TX
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