Provider Demographics
NPI:1073233797
Name:DURAN, KELLEENA SHANNA (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:KELLEENA
Middle Name:SHANNA
Last Name:DURAN
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 S EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:ELK CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73644-9608
Mailing Address - Country:US
Mailing Address - Phone:580-303-5890
Mailing Address - Fax:580-303-5891
Practice Address - Street 1:404 S EASTERN AVE
Practice Address - Street 2:
Practice Address - City:ELK CITY
Practice Address - State:OK
Practice Address - Zip Code:73644-9608
Practice Address - Country:US
Practice Address - Phone:580-303-5890
Practice Address - Fax:580-303-5891
Is Sole Proprietor?:No
Enumeration Date:2022-09-01
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1097082363LF0000X
OK210845363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily