Provider Demographics
NPI:1043205677
Name:DURNING, JENNIFER D (NP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:D
Last Name:DURNING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 MERRIMACK ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-1756
Mailing Address - Country:US
Mailing Address - Phone:978-557-8880
Mailing Address - Fax:978-557-8811
Practice Address - Street 1:500 MERRIMACK ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1981
Practice Address - Country:US
Practice Address - Phone:978-557-8880
Practice Address - Fax:978-557-8811
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA241508363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP3314OtherBLUE CROSS BLUE SHIELD
MAP61291Medicare UPIN
MANP3314OtherBLUE CROSS BLUE SHIELD