Healthcare Provider Details

I. General information

NPI: 1992300933
Provider Name (Legal Business Name): LAUREN NICOLE HURRY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2020
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 RICHMOND RD
LEXINGTON KY
40502-1204
US

IV. Provider business mailing address

1222 W US HIGHWAY 22 AND 3
MAINEVILLE OH
45039-9273
US

V. Phone/Fax

Practice location:
  • Phone: 859-554-8185
  • Fax:
Mailing address:
  • Phone: 210-716-7286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number309663
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: