MEDICARE: MRS. JENNIFER ANN HURLEY FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	NP10186	CO

General Provider Information

NPI Number	:	1841512811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER ANN HURLEY FNP

Provider Business Mailing Address
First Line	:	4602 NORTHPARK DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-3814
Country	:	US
Telephone Number	:	719-265-8668
Fax Number	:

Provider Business Practice Location Address
First Line	:	4602 NORTHPARK DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918
Country	:	US
Telephone Number	:	719-265-8668
Fax Number	:	719-265-5413

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/18/2010
Last Update Date	:	02/18/2010

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