Healthcare Provider Details

I. General information

NPI: 1487759783
Provider Name (Legal Business Name): LINDA M HURT AU D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2917 INDEPENDENCE ST SUITE 200
CAPE GIRARDEAU MO
63703-5025
US

IV. Provider business mailing address

2917 INDEPENDENCE ST SUITE 200
CAPE GIRARDEAU MO
63703-5025
US

V. Phone/Fax

Practice location:
  • Phone: 573-651-4650
  • Fax: 573-651-5212
Mailing address:
  • Phone: 573-651-4650
  • Fax: 573-651-5212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number01354
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number000604
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: