Healthcare Provider Details

I. General information

NPI: 1205840865
Provider Name (Legal Business Name): BARBARA HURST CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 CHANDLER RD #105
MUSKOGEE OK
74403
US

IV. Provider business mailing address

3300 CHANDLER RD #105
MUSKOGEE OK
74403
US

V. Phone/Fax

Practice location:
  • Phone: 918-681-3333
  • Fax: 918-681-3336
Mailing address:
  • Phone: 918-681-3333
  • Fax: 918-681-3336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR0024264
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: