Healthcare Provider Details

I. General information

NPI: 1013486588
Provider Name (Legal Business Name): REBEKAH H HURST NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBEKAH H HEILMAN

II. Dates (important events)

Enumeration Date: 11/14/2018
Last Update Date: 03/31/2022
Certification Date: 03/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 RILEY HOSPITAL DR
INDIANAPOLIS IN
46202-5109
US

IV. Provider business mailing address

PO BOX 1026
INDIANAPOLIS IN
46206-1026
US

V. Phone/Fax

Practice location:
  • Phone: 317-274-4779
  • Fax: 317-948-9806
Mailing address:
  • Phone: 317-777-6435
  • Fax: 317-777-6644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number28203674A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71008639A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: