Healthcare Provider Details

I. General information

NPI: 1710804141
Provider Name (Legal Business Name): WILLIAM GRANT HURLEY APN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 COUNTY ROAD 14
DEL NORTE CO
81132-8758
US

IV. Provider business mailing address

189 HIDDEN VIEW DR
SOUTH FORK CO
81154-9781
US

V. Phone/Fax

Practice location:
  • Phone: 719-657-2510
  • Fax:
Mailing address:
  • Phone: 719-849-8069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPN.1002079-NP
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPN.1002079-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: