Healthcare Provider Details

I. General information

NPI: 1992838106
Provider Name (Legal Business Name): JOYCE ANN HURST RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 DAMERON AVE
KNOXVILLE TN
37917-6413
US

IV. Provider business mailing address

6136 CLINE RD
KNOXVILLE TN
37938-2311
US

V. Phone/Fax

Practice location:
  • Phone: 865-215-5193
  • Fax: 865-215-5199
Mailing address:
  • Phone: 865-215-5193
  • Fax: 865-215-5199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberRN0000074098
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: