Healthcare Provider Details
I. General information
NPI: 1285343640
Provider Name (Legal Business Name): PAMELA JEAN HURLEY AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/15/2022
Last Update Date: 11/15/2022
Certification Date: 11/14/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7250 PARKWAY DR STE 500
HANOVER MD
21076-1343
US
IV. Provider business mailing address
3345 CANNONCADE CT
CHESAPEAKE BEACH MD
20732-4107
US
V. Phone/Fax
- Phone: 410-999-1130
- Fax:
- Phone: 443-624-0298
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LA2100X |
| Taxonomy | Acute Care Nurse Practitioner |
| License Number | R186165 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: