Provider Demographics
NPI:1518987999
Name:DURANT, PRISCILLA A (NP)
Entity Type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:A
Last Name:DURANT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:PRISCILLA
Other - Middle Name:A
Other - Last Name:COLBURN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:191 SOCIAL ST
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895
Mailing Address - Country:US
Mailing Address - Phone:401-767-4163
Mailing Address - Fax:401-767-4165
Practice Address - Street 1:1 RIVER ST
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879
Practice Address - Country:US
Practice Address - Phone:401-783-0523
Practice Address - Fax:401-783-9448
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RINPP15309363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI3844OtherNEIGHBORHOOD HEALTH PLAN
RI7007211Medicaid
RI235286OtherBC
RI3844OtherNEIGHBORHOOD HEALTH PLAN