Healthcare Provider Details

I. General information

NPI: 1467779256
Provider Name (Legal Business Name): GUILFORD ROBERT HURST A.P.N.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2010
Last Update Date: 05/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W 10TH ST
WILMINGTON DE
19801-1422
US

IV. Provider business mailing address

2702 GRUBB RD
WILMINGTON DE
19810-2317
US

V. Phone/Fax

Practice location:
  • Phone: 302-984-3380
  • Fax:
Mailing address:
  • Phone: 302-438-8058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number3645P0809X
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: