Individual
JOHN BRANDON DURHAM
Active
Individual
JOHN BRANDON DURHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
212526
SC
363LF0000X
Family Nurse Practitioner
Primary
21769
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP5083
—
SC
01
—
SCC5297628
MEDICARE PIN
SC
Enumeration date
03/13/2018
Last updated
04/10/2024
Update your record
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