Healthcare Provider Details

I. General information

NPI: 1588183099
Provider Name (Legal Business Name): JENNIFER HURLEY CNM, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2017
Last Update Date: 07/13/2023
Certification Date: 07/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BELLA HEALTH AND WELLNESS INC 2000 VAN NESS, SUITE 304
SAN FRANCISCO CA
94109
US

IV. Provider business mailing address

1161 BANYAN WAY
PACIFICA CA
94044-4343
US

V. Phone/Fax

Practice location:
  • Phone: 415-775-1500
  • Fax:
Mailing address:
  • Phone: 650-580-0035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number235898
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95008010
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: