Individual
MRS. STACEY VAUGHN DURR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CFNP
Contact information
Practice address
1800 BUCKNER ST, SUITE C120, SHREVEPORT, LA 71101-4440
(318) 227-8899
(318) 220-9794
Mailing address
1800 BUCKNER ST, SUITE C120, SHREVEPORT, LA 71101-4440
(318) 227-8899
(318) 220-9794
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP04792 RN060254
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1584355
—
LA
01
—
P00287941
RAILROAD MEDICARE NUMBER
LA
Enumeration date
06/28/2006
Last updated
07/09/2007
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