Healthcare Provider Details

I. General information

NPI: 1366137259
Provider Name (Legal Business Name): NATALIE HURLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2023
Last Update Date: 05/22/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 WOODWARD BLVD
SUMMERVILLE SC
29483-3131
US

IV. Provider business mailing address

206 WOODWARD BLVD
SUMMERVILLE SC
29483-3131
US

V. Phone/Fax

Practice location:
  • Phone: 843-270-1305
  • Fax:
Mailing address:
  • Phone: 843-270-1305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number240181
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number240181
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number240181
License Number StateSC
# 4
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number240181
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: