Provider Demographics
NPI:1821854068
Name:DURDEN, RUSSELL THOMAS (MSN, APRN, AGACNP-BC)
Entity type:Individual
Prefix:MR
First Name:RUSSELL
Middle Name:THOMAS
Last Name:DURDEN
Suffix:
Gender:M
Credentials:MSN, APRN, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 WILDERNESS WAY
Mailing Address - Street 2:
Mailing Address - City:BLAIRSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30512-5062
Mailing Address - Country:US
Mailing Address - Phone:912-309-9206
Mailing Address - Fax:
Practice Address - Street 1:257 MCDOWELL ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2606
Practice Address - Country:US
Practice Address - Phone:828-258-1121
Practice Address - Fax:828-252-6114
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN209339163W00000X, 363LF0000X
NC5020173363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily