Healthcare Provider Details

I. General information

NPI: 1609013960
Provider Name (Legal Business Name): JAMIE P HURST BS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2009
Last Update Date: 01/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 E MAIN ST
HENDERSON TN
38340-1709
US

IV. Provider business mailing address

925 E MAIN ST
HENDERSON TN
38340-1709
US

V. Phone/Fax

Practice location:
  • Phone: 731-989-3401
  • Fax: 731-989-3838
Mailing address:
  • Phone: 731-989-3401
  • Fax: 731-989-3838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: