Provider Demographics
NPI:1316191646
Name:DURBIN, JAMES D (CRNA)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:D
Last Name:DURBIN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2780 - D NEW HOLT RD
Mailing Address - Street 2:BOX 239
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001
Mailing Address - Country:US
Mailing Address - Phone:270-276-6502
Mailing Address - Fax:270-276-6503
Practice Address - Street 1:4645 VILLAGE SQUARE DR STE C
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-7448
Practice Address - Country:US
Practice Address - Phone:270-276-6502
Practice Address - Fax:270-276-6503
Is Sole Proprietor?:No
Enumeration Date:2008-11-13
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1100137367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered