Healthcare Provider Details

I. General information

NPI: 1174440739
Provider Name (Legal Business Name): KAYLEIGH HURST APRN.CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4212 OH-306 BLDG. 2 STE. 100
WILLOUGHBY OH
44094
US

IV. Provider business mailing address

4212 OH-306 BLDG. 2 STE. 100
WILLOUGHBY OH
44094
US

V. Phone/Fax

Practice location:
  • Phone: 440-530-6655
  • Fax:
Mailing address:
  • Phone: 440-530-6655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0042414
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: