Provider Demographics
NPI:1295513992
Name:DURANT, MONESHA (LPN)
Entity type:Individual
Prefix:
First Name:MONESHA
Middle Name:
Last Name:DURANT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1607 MAIN ST APT B510
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01103-1244
Mailing Address - Country:US
Mailing Address - Phone:860-372-6437
Mailing Address - Fax:
Practice Address - Street 1:285 DORSET ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01108-2821
Practice Address - Country:US
Practice Address - Phone:413-214-7806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN92754164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse