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General NPI Number Information
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NPI Number | 1871031823
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Entity Type | Individual
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Provider Name | AMY MARIE DURSO MSN, RN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/09/2017
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 15838 FOUNTAIN PLAZA DR STE A
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City | CHESTERFIELD
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State | MO
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Zip | 63017-7469
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Country | US
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Telephone | 636-484-5277
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Fax | 636-484-5216
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Provider Business Mailing Address
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Address Line | PO BOX 959354
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City | SAINT LOUIS
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State | MO
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Zip | 63195-9354
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Country | US
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Telephone | 636-484-5277
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Fax | 636-484-5216
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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 | 209.15420
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License Number State | IL
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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 | 2016039171
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2016039171
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License Number State | MO
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