Provider Demographics
NPI:1912655929
Name:DUREN, KIMBERLY A (MS)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:A
Last Name:DUREN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:KIMBERLY
Other - Middle Name:A
Other - Last Name:DUREN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:1821 HILLANDALE RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-2659
Mailing Address - Country:US
Mailing Address - Phone:919-660-3153
Mailing Address - Fax:
Practice Address - Street 1:1821 HILLANDALE RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2659
Practice Address - Country:US
Practice Address - Phone:919-660-3153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-17
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise PhysiologistGroup - Single Specialty