Healthcare Provider Details

I. General information

NPI: 1275253973
Provider Name (Legal Business Name): EMILY HULBURT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2022
Last Update Date: 09/01/2022
Certification Date: 08/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E BROAD ST WEST HOSPITAL, 5TH FLOOR, SOUTH WING, ROOM 303
RICHMOND VA
23298-5025
US

IV. Provider business mailing address

1614 LABURNUM PARK BLVD
RICHMOND VA
23227-4408
US

V. Phone/Fax

Practice location:
  • Phone: 804-512-7446
  • Fax: 804-828-7710
Mailing address:
  • Phone: 804-512-7446
  • Fax: 804-828-7710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number0024185029
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: