Provider Demographics
NPI:1942051115
Name:CARROLL-DURDEN, DEMERRIA
Entity Type:Individual
Prefix:
First Name:DEMERRIA
Middle Name:
Last Name:CARROLL-DURDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2014 TORBENSON DR
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44112
Mailing Address - Country:US
Mailing Address - Phone:216-502-5918
Mailing Address - Fax:
Practice Address - Street 1:10600 ST CLAIR AVENUE APT 603
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44108
Practice Address - Country:US
Practice Address - Phone:216-502-5918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker