Healthcare Provider Details

I. General information

NPI: 1861160160
Provider Name (Legal Business Name): KAREN E HURST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2021
Last Update Date: 09/01/2021
Certification Date: 09/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2810 N SWAN ST
SILVER CITY NM
88061-5800
US

IV. Provider business mailing address

2810 N SWAN ST
SILVER CITY NM
88061-5800
US

V. Phone/Fax

Practice location:
  • Phone: 575-956-2132
  • Fax:
Mailing address:
  • Phone: 575-956-2132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number59915
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: