Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 1-145939 | AL |
NPI | 1003466228 |
---|---|
Provider Name | Mr. Ryne Scott Duren |
First Address | Birmingham, AL 35242-7320 |
Second Address | Birmingham, AL 35249-1900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2019 |
Last Update Date | 19/09/2019 |