Healthcare Provider Details

I. General information

NPI: 1598218950
Provider Name (Legal Business Name): ERIN HURST MS, RDN, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2016
Last Update Date: 12/14/2023
Certification Date: 12/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6910 N MAIN ST UNIT 24A
GRANGER IN
46530-8845
US

IV. Provider business mailing address

59741 TYHOLLAND LN
MISHAWAKA IN
46544-9715
US

V. Phone/Fax

Practice location:
  • Phone: 574-440-8700
  • Fax: 574-440-8701
Mailing address:
  • Phone: 574-440-8700
  • Fax: 574-440-8701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number37002369A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: