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General NPI Number Information
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NPI Number | 1194054312
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Entity Type | Individual
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Provider Name | PHILLIP ROSS HURD FNP
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Gender | Male
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Dates
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Enumeration Date | 12/17/2009
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Last Update Date | 05/27/2024
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Provider Practice Location Address
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Address Line | 6000 W HIGHWAY 98
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City | PENSACOLA
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State | FL
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Zip | 32512-3011
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Country | US
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Telephone | 901-874-4202
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Fax | 840-452-5638
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Provider Business Mailing Address
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Address Line | 6000 W HIGHWAY 98
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City | PENSACOLA
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State | FL
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Zip | 32512-0001
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Country | US
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Telephone | 901-874-4202
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Fax | 850-452-5638
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2009037132
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License Number State | MO
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