Provider Demographics
NPI:1821700022
Name:DURRANCE, BERKELEY (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:BERKELEY
Middle Name:
Last Name:DURRANCE
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 S GLEN AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-4682
Mailing Address - Country:US
Mailing Address - Phone:813-480-0459
Mailing Address - Fax:
Practice Address - Street 1:4807 BAYSHORE BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33611-2820
Practice Address - Country:US
Practice Address - Phone:813-443-5134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11022119363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily