Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 2018023176 | MO |
N | 363LN0000X | Nurse Practitioner - Neonatal | CNP5066 | MN |
NPI | 1184162349 |
---|---|
Provider Name | Paul Duray |
First Address | Kansas City, MO 64180-1143 |
Second Address | Cape Girardeau, MO 63703-5049 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2017 |
Last Update Date | 02/03/2021 |