Provider Demographics
NPI:1497281935
Name:DURKIN, NICOLE ERIN (NP)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:ERIN
Last Name:DURKIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:E
Other - Last Name:GRAESSLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1931 LANCASTER ST
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-1608
Mailing Address - Country:US
Mailing Address - Phone:313-363-4244
Mailing Address - Fax:
Practice Address - Street 1:1931 LANCASTER ST
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE WOODS
Practice Address - State:MI
Practice Address - Zip Code:48236-1608
Practice Address - Country:US
Practice Address - Phone:313-363-4244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-03
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704263349363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner