Healthcare Provider Details

I. General information

NPI: 1306592498
Provider Name (Legal Business Name): BRIDGET HURLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2022
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2628 SE WILLOUGHBY BLVD
STUART FL
34994-4700
US

IV. Provider business mailing address

108 SW MILBURN CIR
PORT ST LUCIE FL
34953-5501
US

V. Phone/Fax

Practice location:
  • Phone: 772-300-9047
  • Fax: 772-273-6540
Mailing address:
  • Phone: 404-692-8248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11022536
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: