Provider Demographics
NPI:1043503956
Name:DURWARD, JENNIFER ANNE (APRN, PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ANNE
Last Name:DURWARD
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:ANNE
Other - Last Name:KNUDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:311 3RD ST
Mailing Address - Street 2:
Mailing Address - City:HAVRE
Mailing Address - State:MT
Mailing Address - Zip Code:59501-3515
Mailing Address - Country:US
Mailing Address - Phone:406-945-9019
Mailing Address - Fax:406-430-0176
Practice Address - Street 1:311 3RD ST
Practice Address - Street 2:
Practice Address - City:HAVRE
Practice Address - State:MT
Practice Address - Zip Code:59501-3515
Practice Address - Country:US
Practice Address - Phone:406-945-9019
Practice Address - Fax:406-430-0176
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-25
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT100480363LP0808X
MT27449363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT62308OtherALLEGIANCE/CIGNA
MT1740807502Medicaid
MT87729OtherUNITED HEALTH CARE
MT892299098OtherBLUE CROSS BLUE SHEILD
MT91131OtherFIRST CHOICE
MT87729OtherOPTUM
MT93029OtherPACIFIC SOURCE
MT84137OtherINTERWEST