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Individual

JELISA DURROH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
WHNP-BC

Contact information

Practice address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-5303
(409) 772-6803
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-0000
(410) 500-4266

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
AC008124
MD
363LW0102X
Women's Health Nurse Practitioner
Primary
1095185
TX
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
1095185
TX

Other

Enumeration date
01/12/2024
Last updated
12/05/2025
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