Individual
TERRY D DURHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
520 W GUM ST, MARION, KY 42064-1516
(270) 965-5281
(270) 965-4852
Mailing address
PO BOX 386, MARION, KY 42064-0386
(270) 965-5281
(270) 965-4852
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1069081
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000066369
ANTHEM
OH
01
—
430056263
RAILROAD MEDICARE
KY
05
—
74408006
—
KY
Enumeration date
06/15/2006
Last updated
08/14/2014
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