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NPI Code Detail

MEDICARE: MRS. TERESA B DURDEN ACNP

MEDICARE: MRS. TERESA B DURDEN ACNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2100XAcute Care Nurse Practitioner2296SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790763613
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TERESA B DURDEN ACNP
Provider Business Mailing Address
First Line : PO BOX 743904
Second Line :
City : ATLANTA
State : GA
Zip : 30374-3904
Country : US
Telephone Number : 803-296-7320
Fax Number : 803-296-7330
Provider Business Practice Location Address
First Line : 300 PALMETTO HEALTH PKWY STE 401
Second Line :
City : COLUMBIA
State : SC
Zip : 29212-1764
Country : US
Telephone Number : 803-296-3273
Fax Number : 803-296-7061
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2006
Last Update Date : 06/04/2021

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