Individual
ELLEN F DURST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS,RD,LD
Contact information
Practice address
1997 MEDICAL PARK DR, GREENVILLE, MS 38703-7268
(662) 335-4105
(662) 378-2879
Mailing address
508 GERALD ST, LELAND, MS 38756-3125
(662) 335-4105
(662) 378-2879
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D1347
MS
Other
Enumeration date
06/06/2011
Last updated
06/06/2011
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