Provider Demographics
NPI:1770327959
Name:DURAN, ZOE ANN (RD)
Entity type:Individual
Prefix:
First Name:ZOE
Middle Name:ANN
Last Name:DURAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4706 GRAY LOOP UNIT D
Mailing Address - Street 2:
Mailing Address - City:JBER
Mailing Address - State:AK
Mailing Address - Zip Code:99506-4622
Mailing Address - Country:US
Mailing Address - Phone:907-312-0504
Mailing Address - Fax:
Practice Address - Street 1:4706 GRAY LOOP UNIT D
Practice Address - Street 2:
Practice Address - City:JBER
Practice Address - State:AK
Practice Address - Zip Code:99506-4622
Practice Address - Country:US
Practice Address - Phone:907-312-0504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK86278144133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered