Individual
KIMBERLY K DURHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1040 GULF BREEZE PKWY, STE 100, GULF BREEZE, FL 32561-7809
(850) 916-8500
(850) 916-8509
Mailing address
6831 HALCYON PARK DR, MONTGOMERY, AL 36117-6972
(334) 396-6930
(334) 396-6929
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN3216652
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ARNP3216652
ARNP LICENSE
FL
01
—
EMT87949
EMT LICENSE
FL
01
—
PMD200872
PARAMEDIC LICENSE
FL
01
—
RN3216652
RN LICENSE
FL
Enumeration date
05/20/2010
Last updated
05/20/2010
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