Healthcare Provider Details
I. General information
NPI: 1487524336
Provider Name (Legal Business Name): KRISTIN AMY HURL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/06/2025
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9095 RIO SAN DIEGO DR STE 425
SAN DIEGO CA
92108-1679
US
IV. Provider business mailing address
2664 MOBLEY ST
SAN DIEGO CA
92123-3031
US
V. Phone/Fax
- Phone: 858-455-5524
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WI0500X |
| Taxonomy | Infusion Therapy Registered Nurse |
| License Number | 95050163 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WX0200X |
| Taxonomy | Oncology Registered Nurse |
| License Number | 95050163 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: