Healthcare Provider Details

I. General information

NPI: 1548793912
Provider Name (Legal Business Name): TIFFANY K. HURD ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2017
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 MANATEE AVE W STE A
BRADENTON FL
34209-2357
US

IV. Provider business mailing address

6400 MANATEE AVE W STE A
BRADENTON FL
34209-2357
US

V. Phone/Fax

Practice location:
  • Phone: 941-761-8505
  • Fax:
Mailing address:
  • Phone: 941-761-8505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9234209
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: