Healthcare Provider Details

I. General information

NPI: 1033276589
Provider Name (Legal Business Name): ADRIENNE LYNN HURLEY N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 05/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 W 10TH ST
INDIANAPOLIS IN
46202-2859
US

IV. Provider business mailing address

2621 BLUFFWOOD DR W
INDIANAPOLIS IN
46228-2917
US

V. Phone/Fax

Practice location:
  • Phone: 317-630-2588
  • Fax:
Mailing address:
  • Phone: 317-387-1439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71002293A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: