Healthcare Provider Details

I. General information

NPI: 1861774093
Provider Name (Legal Business Name): KIMBERLY ANN HURLEY MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS KIMBERLY ANN FISHER

II. Dates (important events)

Enumeration Date: 09/14/2011
Last Update Date: 06/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 CENTRAL AVE.
SEARCY AR
72143
US

IV. Provider business mailing address

118 CENTRAL AVE.
SEARCY AR
72143
US

V. Phone/Fax

Practice location:
  • Phone: 501-305-3305
  • Fax: 501-279-0760
Mailing address:
  • Phone: 501-305-3305
  • Fax: 501-279-0760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOTR2453
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: