Healthcare Provider Details

I. General information

NPI: 1154181923
Provider Name (Legal Business Name): KRISTEN MICHELLE HURT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2024
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MEDICAL CENTER DR STE 1A
HAZARD KY
41701-9477
US

IV. Provider business mailing address

PO BOX 418
HAZARD KY
41702-0418
US

V. Phone/Fax

Practice location:
  • Phone: 606-439-5220
  • Fax: 606-439-5221
Mailing address:
  • Phone: 606-233-4837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4017369
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: