Provider Demographics
NPI:1659541738
Name:DUARTE, GLORIA LYNN (MSN, WHNP, RN)
Entity Type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:LYNN
Last Name:DUARTE
Suffix:
Gender:F
Credentials:MSN, WHNP, RN
Other - Prefix:MS
Other - First Name:GLORIA
Other - Middle Name:LYNN
Other - Last Name:BANDONI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, WHNP, RN
Mailing Address - Street 1:6969 BROCKTON AVE., SUITE A & B
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506
Mailing Address - Country:US
Mailing Address - Phone:951-503-8989
Mailing Address - Fax:951-530-8877
Practice Address - Street 1:6969 BROCKTON AVE., SUITE A & B
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-4001
Practice Address - Country:US
Practice Address - Phone:951-530-8989
Practice Address - Fax:951-530-8877
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9009363LX0001X, 364SW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's Health