Provider Demographics
NPI:1528570538
Name:DURAN, RUSTY RIVERA (APRN-C, PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:RUSTY
Middle Name:RIVERA
Last Name:DURAN
Suffix:
Gender:F
Credentials:APRN-C, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 HAMPTON HWY
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23693-3512
Mailing Address - Country:US
Mailing Address - Phone:757-865-1843
Mailing Address - Fax:757-865-7485
Practice Address - Street 1:205 HAMPTON HWY
Practice Address - Street 2:
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23693-3512
Practice Address - Country:US
Practice Address - Phone:757-865-1843
Practice Address - Fax:757-865-7485
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-31
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024175558363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health