Healthcare Provider Details

I. General information

NPI: 1326805425
Provider Name (Legal Business Name): SARA K HURLEY FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2024
Last Update Date: 03/28/2024
Certification Date: 03/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 3RD ST NW
HARLOWTON MT
59036-5229
US

IV. Provider business mailing address

202 W ARTEMOS DR
MISSOULA MT
59803-1512
US

V. Phone/Fax

Practice location:
  • Phone: 406-632-4351
  • Fax:
Mailing address:
  • Phone: 406-546-8883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberNUR-APRN-LIC-213526
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: