Provider Demographics
NPI:1639849011
Name:DURDEN, MAKAYLA (RN)
Entity Type:Individual
Prefix:MISS
First Name:MAKAYLA
Middle Name:
Last Name:DURDEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MAKAYLA
Other - Middle Name:
Other - Last Name:DURDEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:10104 NW 240TH TER
Mailing Address - Street 2:
Mailing Address - City:ALACHUA
Mailing Address - State:FL
Mailing Address - Zip Code:32615-7868
Mailing Address - Country:US
Mailing Address - Phone:334-341-0898
Mailing Address - Fax:
Practice Address - Street 1:10104 NW 240TH TER
Practice Address - Street 2:
Practice Address - City:ALACHUA
Practice Address - State:FL
Practice Address - Zip Code:32615-7868
Practice Address - Country:US
Practice Address - Phone:334-341-0898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9575431163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse