Provider Demographics
NPI:1578397022
Name:DURIS, ANGELA JEAN
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:JEAN
Last Name:DURIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2963 EDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:MI
Mailing Address - Zip Code:48133-9711
Mailing Address - Country:US
Mailing Address - Phone:419-349-8536
Mailing Address - Fax:
Practice Address - Street 1:3453 FOREST GROVE DR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4104
Practice Address - Country:US
Practice Address - Phone:567-249-9597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant