Durel, Jeremy Brockford

Durel, Jeremy Brockford is an individual health care provider with primary practice located at 4700 Waters Ave , Savannah GA 31404-6220. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Durel, Jeremy Brockford can be contacted via phone (912) 354-3510.

Contact Information

Primary practice address
4700 Waters Ave Savannah GA 31404-6220
Phone: (912) 354-3510
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X R130642 Maryland

Profile Details

NPI number 1518909084
LBN Legal business name Durel, Jeremy Brockford
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 11th, 2006
Last updated Jan 10th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518909084 NPPES
Maryland MEDICAID 436203900
Maryland Other 202I430853
Maryland MEDICAID 244337472A

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