Provider Demographics
NPI:1275084972
Name:DURR, LAURA MYRICK (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:MYRICK
Last Name:DURR
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 PLANTATION DR
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-5715
Mailing Address - Country:US
Mailing Address - Phone:784-447-0356
Mailing Address - Fax:
Practice Address - Street 1:205 PLANTATION DR
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-5715
Practice Address - Country:US
Practice Address - Phone:478-447-0356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-18
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN201825363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner