Healthcare Provider Details

I. General information

NPI: 1194480830
Provider Name (Legal Business Name): NATALIE HURLBURT NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2021
Last Update Date: 11/08/2021
Certification Date: 11/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33-57 HARRISON ST
JOHNSON CITY NY
13790-2107
US

IV. Provider business mailing address

20 DICKINSON AVE
BINGHAMTON NY
13901-1714
US

V. Phone/Fax

Practice location:
  • Phone: 607-763-6661
  • Fax: 607-763-6563
Mailing address:
  • Phone: 607-760-4110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF348506
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: