Individual
MILDRED C DURANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
331 LAIDLEY ST, SUITE 606, CHARLESTON, WV 25301-1619
(304) 344-0096
Mailing address
1824 LOUDEN HEIGHTS RD, CHARLESTON, WV 25314-1565
(304) 346-4438
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
009308
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0067106000
—
WV
Enumeration date
01/25/2007
Last updated
07/09/2007
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