Provider Demographics
NPI:1992175160
Name:DURHAM, EVELYN MORRIS (FNP)
Entity type:Individual
Prefix:MS
First Name:EVELYN
Middle Name:MORRIS
Last Name:DURHAM
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12815 US HIGHWAY 84 E
Mailing Address - Street 2:
Mailing Address - City:JOAQUIN
Mailing Address - State:TX
Mailing Address - Zip Code:75954-2440
Mailing Address - Country:US
Mailing Address - Phone:936-269-3201
Mailing Address - Fax:
Practice Address - Street 1:12815 US HIGHWAY 84 E
Practice Address - Street 2:
Practice Address - City:JOAQUIN
Practice Address - State:TX
Practice Address - Zip Code:75954-2440
Practice Address - Country:US
Practice Address - Phone:936-269-3201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-30
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129168363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily