Provider Demographics
NPI:1477361475
Name:DURANT, JAKOBE
Entity type:Individual
Prefix:
First Name:JAKOBE
Middle Name:
Last Name:DURANT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 SANDBAR CT NE UNIT M
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55906-2645
Mailing Address - Country:US
Mailing Address - Phone:469-928-5038
Mailing Address - Fax:
Practice Address - Street 1:184 SANDBAR CT NE UNIT M
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55906-2645
Practice Address - Country:US
Practice Address - Phone:469-928-5038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-21
Last Update Date:2024-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter