Provider Demographics
NPI:1780027581
Name:DURAZO, LYNN A (PHARMD)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:A
Last Name:DURAZO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16400 S TOWNSEND AVE
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-5404
Mailing Address - Country:US
Mailing Address - Phone:970-240-1994
Mailing Address - Fax:970-240-3012
Practice Address - Street 1:16400 S TOWNSEND AVE
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-5404
Practice Address - Country:US
Practice Address - Phone:970-240-1994
Practice Address - Fax:970-240-3012
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18613183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist