Provider Demographics
NPI:1720226442
Name:DURBIN, PATTI S (CRNA)
Entity Type:Individual
Prefix:
First Name:PATTI
Middle Name:S
Last Name:DURBIN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 FRANCISCAN DR
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62056-1778
Mailing Address - Country:US
Mailing Address - Phone:217-324-8547
Mailing Address - Fax:
Practice Address - Street 1:1215 FRANCISCAN DRIVE
Practice Address - Street 2:ANESTHESIA DEPT
Practice Address - City:LITCHFIELD
Practice Address - State:IL
Practice Address - Zip Code:62056
Practice Address - Country:US
Practice Address - Phone:217-324-2191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-03
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209007458367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL081060OtherANCC CERTIFICATION