Provider Demographics
NPI:1003649369
Name:DURNIN, ANNA LOUISE
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:LOUISE
Last Name:DURNIN
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 1:1220 WINDY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-6486
Mailing Address - Country:US
Mailing Address - Phone:228-596-6288
Mailing Address - Fax:
Practice Address - Street 1:428 RIDGEFIELD RD
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-2913
Practice Address - Country:US
Practice Address - Phone:984-291-4218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician