Provider Demographics
NPI:1184122046
Name:DURBIN, DANIEL JOSEPH LUNSFORD (PA-C)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:JOSEPH LUNSFORD
Last Name:DURBIN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:DANIEL
Other - Middle Name:JOSEPH
Other - Last Name:DURBIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7300 147TH ST W STE 204
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-7850
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7300 147TH ST W STE 204
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-7850
Practice Address - Country:US
Practice Address - Phone:952-997-3020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-25
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical