Individual provider Active NPI

Michelle Durham, APRN

  • Adult Health Nurse Practitioner
  • Erlanger, KY
National Provider Identifier
1619524733
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
3010241 Issued in KY
Practice address
236 Wendel H Ford Blvd
Erlanger, KY 41018-1272
Phone
(859) 444-2871
Fax
(859) 817-8559
NPI assigned
Aug 22, 2019
Last updated
Aug 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 3010241 KY Primary

Addresses

Primary practice location

236 Wendel H Ford Blvd
Erlanger, KY 41018-1272

Mailing address

4123 Olympic Blvd Ste 151
Erlanger, KY 41018-3508
Phone (859) 301-2999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3010241KYMDAdult Health Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1619524733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4123 OLYMPIC BLVD STE 151",
            "city": "ERLANGER",
            "state": "KY",
            "postal_code": "410183508",
            "telephone_number": "859-301-2999",
            "fax_number": "859-301-2984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 WENDEL H FORD BLVD",
            "city": "ERLANGER",
            "state": "KY",
            "postal_code": "410181272",
            "telephone_number": "859-444-2871",
            "fax_number": "859-817-8559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURHAM",
        "first_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-22",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "KY",
            "license": "3010241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erlanger, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.