Provider Demographics
NPI:1083304851
Name:DURANT, JAYNE (FNP)
Entity Type:Individual
Prefix:MS
First Name:JAYNE
Middle Name:
Last Name:DURANT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22101 BURBANK BLVD
Mailing Address - Street 2:UNIT 5
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-6205
Mailing Address - Country:US
Mailing Address - Phone:310-776-0480
Mailing Address - Fax:
Practice Address - Street 1:22101 BURBANK BLVD
Practice Address - Street 2:UNIT 5
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-6205
Practice Address - Country:US
Practice Address - Phone:310-776-0480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95023916363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily