Provider Demographics
NPI:1528765419
Name:DUREN, AMBER NICHOLE
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:NICHOLE
Last Name:DUREN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4212 PEARL AVE
Mailing Address - Street 2:
Mailing Address - City:SOPHIA
Mailing Address - State:NC
Mailing Address - Zip Code:27350-8320
Mailing Address - Country:US
Mailing Address - Phone:336-590-6221
Mailing Address - Fax:
Practice Address - Street 1:4212 PEARL AVE
Practice Address - Street 2:
Practice Address - City:SOPHIA
Practice Address - State:NC
Practice Address - Zip Code:27350-8320
Practice Address - Country:US
Practice Address - Phone:336-590-6221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X
NC253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care