Healthcare Provider Details

I. General information

NPI: 1275991663
Provider Name (Legal Business Name): TIMOTHY HURST APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2016
Last Update Date: 10/23/2020
Certification Date: 10/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 MEDICAL CENTER DR
NASHVILLE TN
37232-1090
US

IV. Provider business mailing address

286 HUGHES RD
ALBANY KY
42602-6641
US

V. Phone/Fax

Practice location:
  • Phone: 615-936-0770
  • Fax:
Mailing address:
  • Phone: 606-387-0680
  • Fax: 615-988-1635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP143110
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3010057
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: