Provider Demographics
NPI:1427839935
Name:DRURY, DONALD BURNELL (APRN)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:BURNELL
Last Name:DRURY
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 MAIN ST FL 2
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15901-1601
Mailing Address - Country:US
Mailing Address - Phone:814-534-1095
Mailing Address - Fax:
Practice Address - Street 1:320 MAIN ST FL 2
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15901-1601
Practice Address - Country:US
Practice Address - Phone:814-534-1095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-10
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK215487363LP0808X
PASP030727363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health