Provider Demographics
NPI:1346320058
Name:DURST, EUGENIA S (FNP)
Entity type:Individual
Prefix:MS
First Name:EUGENIA
Middle Name:S
Last Name:DURST
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:EUGENIA
Other - Middle Name:S
Other - Last Name:DURST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:W9394 EVERGREEN LANE
Mailing Address - Street 2:
Mailing Address - City:MERRILLAN
Mailing Address - State:WI
Mailing Address - Zip Code:54754
Mailing Address - Country:US
Mailing Address - Phone:715-743-8013
Mailing Address - Fax:
Practice Address - Street 1:500 EAST VETERANS ST
Practice Address - Street 2:
Practice Address - City:TOMAH
Practice Address - State:WI
Practice Address - Zip Code:54660
Practice Address - Country:US
Practice Address - Phone:608-372-3971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC341716-22363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily