Healthcare Provider Details

I. General information

NPI: 1275117889
Provider Name (Legal Business Name): EMILY ANN HURST CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2021
Last Update Date: 06/23/2023
Certification Date: 06/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 MEDICAL PARK DR E
BIRMINGHAM AL
35235-3401
US

IV. Provider business mailing address

7973 ELI CIR
TRUSSVILLE AL
35173-2472
US

V. Phone/Fax

Practice location:
  • Phone: 205-838-3000
  • Fax:
Mailing address:
  • Phone: 205-527-4027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1-147282
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: