Provider Demographics
NPI:1245380179
Name:DURAN, GERRI ANN (MS)
Entity Type:Individual
Prefix:MS
First Name:GERRI
Middle Name:ANN
Last Name:DURAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4920 CALLE DE TIERRA NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2927
Mailing Address - Country:US
Mailing Address - Phone:505-299-2844
Mailing Address - Fax:505-237-2020
Practice Address - Street 1:401 N 2ND ST
Practice Address - Street 2:
Practice Address - City:GRANTS
Practice Address - State:NM
Practice Address - Zip Code:87020-2507
Practice Address - Country:US
Practice Address - Phone:505-299-2844
Practice Address - Fax:505-237-2020
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM72225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist