MS. THERESA M DURLEY (NPI# 1194707448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194707448 |
| Entity Type | Individual |
| Full Name | MS. THERESA M DURLEY |
| Other Name | THERESA M DURLEY |
| Credential | NP |
| Practice Address |
1401 Presque Isle Avenue Health Center - Lower Gries Marquette MI 49855 |
| Practice Telephone | 9062272355 |
| Practice Fax Number | 9062272332 |
| Mailing Telephone | 9062272355 |
| Mailing Fax Number | 9062272332 |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2019-02-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
4704131080 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 367500000X | Nurse Anesthetist, Certified Registered | 4704131080 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 104654110 | 05 | |
| MI | BLUESHIELD PIN | TD131080 | 01 |
| WI | WISC MEDICAID PIN | 44337600 | 01 |
| Street Address |
1401 PRESQUE ISLE AVENUE HEALTH CENTER - LOWER GRIES |
| City | MARQUETTE |
| State | MI |
| Zip Code | 49855 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245221076 | David Michael Luoma | Family Medicine | 1401 Presque Isle Avenue, Northern Michigan University Vielmetti Health Center, Marquette, MI 49855 | 2005-11-01 |
| 1821552126 | Northern Michigan University | Assistant Behavior Analyst | 1401 Presque Isle Avenue, 158 Services Building, Marquette, MI 49855 | 2019-01-31 |
| 1760760839 | Michele Lee Premeau | Nurse Practitioner | 1401 Presque Isle Avenue, Health Center, Marquette, MI 49855 | 2011-07-23 |
| 1396894200 | Northern Michigan University | Clinic/Center | 1401 Presque Isle Avenue, Marquette, MI 49855 | 2007-01-09 |
| 1154373090 | Kayleen P Papin | Family Medicine | 1401 Presque Isle Avenue, Health Center, Marquette, MI 49855 | 2006-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023665064 | Scott Allen Poirier | Physician Assistant | 850 West Baraga Avenue, Marquette, MI 49855 | 2019-08-23 |
| 1730734831 | Katelyn Tourville | Physician Assistant | 1401 Presque Isle Ave-health Center, Marquette, MI 49855 | 2019-08-06 |
| 1932681095 | Katelyn Longanbach | Physical Therapist | 841 W Washington St Ste 500, Marquette, MI 49855 | 2018-09-05 |
| 1366943979 | Meijer, Inc. | Durable Medical Equipment & Medical Supplies | 3630 Us 41 W, Marquette, MI 49855 | 2018-02-28 |
| 1518466143 | Orthopaedic Surgery Associates of Marquette PC | Prosthetic/Orthotic Supplier | 841 West Washington Street, Suite 100, Marquette, MI 49855 | 2018-02-09 |
| 1376075598 | Pamela Baynton | Licensed Practical Nurse | 2292 U.S. 41 W, Marquette, MI 49855 | 2017-03-28 |
| 1548709454 | Allison Jean Czarny | Registered Nurse | 160 E Wright Pl, Marquette, MI 49855 | 2017-02-13 |
| 1629427299 | Larry Chappel | Social Worker | 210 Chippewa Square, Suite 208, Marquette, MI 49855 | 2016-06-06 |
| 1366898348 | Carla Pate | Student in an Organized Health Care Education/Training Program | 235 Hunt Hall, Marquette, MI 49855 | 2016-05-10 |
| 1922479732 | Nicholas Wujcik | Student in an Organized Health Care Education/Training Program | 504 S Fifth St, Marquette, MI 49855 | 2015-10-20 |
| Find all providers in zip 49855 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487284758 | Danielle Sandstrom | Nurse Practitioner | 2003 Summit St, Marquette, MI 49855-1441 | 2020-01-24 |
| 1003349937 | Lisa Lee Smith | Nurse Practitioner | 1414 W Fair Ave Ste 35, Marquette, MI 49855-2675 | 2017-04-07 |
| 1083015424 | Michelle Dawn Johnson | Nurse Practitioner | 2003 Orchard St, Marquette, MI 49855 | 2014-09-04 |
| 1336548817 | Erika Suzanne Kielhorn Hefke | Nurse Practitioner | 323 W Hewitt Ave, Marquette, MI 49855-3415 | 2014-08-20 |
| 1790081370 | Gloria J Clocklin | Nurse Practitioner | 1623 Gray St, Marquette, MI 49855-1541 | 2011-01-31 |
| 1689823247 | Nina Rae Van Den Ende | Nurse Practitioner | 3032 N Lakeshore Blvd, Marquette, MI 49855-2023 | 2008-09-18 |
| 1073148409 | Rachel Bonsall | Nurse Practitioner | 850 W Baraga Ave, Marquette, MI 49855-4550 | 2020-03-05 |
| 1720646508 | Suunta Integrative Health | Nurse Practitioner | 1209 N 3rd St, Marquette, MI 49855-3009 | 2019-06-05 |
| 1154885184 | Rachel Michelle Nye | Nurse Practitioner | 1401 Presque Isle Ave, Marquette, MI 49855-2818 | 2019-01-23 |
| 1568931921 | Bryan Francis Harris | Nurse Practitioner | 580 W College Ave, Marquette, MI 49855-2736 | 2018-11-15 |
| Find all providers in MARQUETTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.