Individual
MRS. CLARICE O Y DURDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
7709 CONNECTICUT AVE, CLEVELAND, OH 44105-5903
(216) 502-8205
Mailing address
7709 CONNECTICUT AVE, CLEVELAND, OH 44105-5903
(216) 502-8205
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN149816
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0070898
—
OH
Enumeration date
08/22/2012
Last updated
01/02/2015
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