Individual
JENNIFER ROSE DURHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
10003 WEBSTER RD, CAMDEN ON GAULEY, WV 26208-7713
(304) 226-5725
(304) 226-3274
Mailing address
10003 WEBSTER RD, CAMDEN ON GAULEY, WV 26208-7713
(304) 226-5725
(304) 226-3274
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
73253
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810026528
—
WV
01
—
WV3488A
MEDICARE
WV
Enumeration date
09/11/2013
Last updated
01/11/2023
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