Healthcare Provider Details

I. General information

NPI: 1588301485
Provider Name (Legal Business Name): KATIA HURT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2022
Last Update Date: 05/13/2022
Certification Date: 05/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 21ST AVE S STE 410
NASHVILLE TN
37212-4350
US

IV. Provider business mailing address

6316 WILLOW OAK DR
NASHVILLE TN
37221-3996
US

V. Phone/Fax

Practice location:
  • Phone: 615-492-6700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: