Healthcare Provider Details

I. General information

NPI: 1336874965
Provider Name (Legal Business Name): TREASURE HURST RN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2022
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 E CHESTNUT ST # STREET6
LOUISVILLE KY
40202-1713
US

IV. Provider business mailing address

4803 OLYMPIA PARK PLZ STE 1100
LOUISVILLE KY
40241-3068
US

V. Phone/Fax

Practice location:
  • Phone: 502-588-3650
  • Fax: 502-272-5339
Mailing address:
  • Phone: 502-559-9438
  • Fax: 502-272-5339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3018061
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: