Provider Demographics
NPI:1982192027
Name:DURANT, PORCHIA
Entity Type:Individual
Prefix:
First Name:PORCHIA
Middle Name:
Last Name:DURANT
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 1:5685 WESTPOINT ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48125-2351
Mailing Address - Country:US
Mailing Address - Phone:248-910-4663
Mailing Address - Fax:313-633-5085
Practice Address - Street 1:7436 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-3100
Practice Address - Country:US
Practice Address - Phone:248-910-4663
Practice Address - Fax:313-633-0585
Is Sole Proprietor?:No
Enumeration Date:2018-04-24
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist