Provider Demographics
NPI:1437453842
Name:DURHAM FOUST, NANCY Y (ARNP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:Y
Last Name:DURHAM FOUST
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10300 SW 216TH STREET
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33190
Mailing Address - Country:US
Mailing Address - Phone:305-253-5100
Mailing Address - Fax:305-254-4901
Practice Address - Street 1:810 W MOWRY DR
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-5746
Practice Address - Country:US
Practice Address - Phone:305-248-4334
Practice Address - Fax:305-245-1161
Is Sole Proprietor?:No
Enumeration Date:2010-12-28
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1843012363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003270400Medicaid
EU274ZMedicare PIN