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Individual

SANDRA M DURRENCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1061 HARMON AVE STE 1003, FORT STEWART, GA 31314-5641
(912) 435-6633
Mailing address
1061 HARMON AVE STE 1003, FORT STEWART, GA 31314-5641
(912) 435-6633

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN077240
GA
363L00000X
Nurse Practitioner
Primary
RN077240
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000680215M
GA
Enumeration date
07/10/2006
Last updated
07/09/2012
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