Provider Demographics
NPI:1760584502
Name:DURKEE, VICTORIA TODD (APRN, PHD, CNS)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:TODD
Last Name:DURKEE
Suffix:
Gender:F
Credentials:APRN, PHD, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 MALLORY PL
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-4509
Mailing Address - Country:US
Mailing Address - Phone:318-355-6559
Mailing Address - Fax:
Practice Address - Street 1:141 DESIARD ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-7385
Practice Address - Country:US
Practice Address - Phone:318-322-8462
Practice Address - Fax:318-322-8472
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP02630364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LARN061503OtherRN
LAAP02630OtherAPRN
MSR544868OtherRN