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General NPI Number Information
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NPI Number | 1487120614
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Entity Type | Individual
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Provider Name | DALLAS WELBORN HURLEY FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/15/2018
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Last Update Date | 10/15/2018
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Provider Practice Location Address
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Address Line | 2222 S FAYETTEVILLE ST STE B
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City | ASHEBORO
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State | NC
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Zip | 27205
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Country | US
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Telephone | 336-318-6200
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Fax | 336-636-7686
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Provider Business Mailing Address
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Address Line | 2222 S FAYETTEVILLE ST STE B
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City | ASHEBORO
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State | NC
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Zip | 27205-7368
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Country | US
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Telephone | 336-318-6200
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Fax | 336-636-7686
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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 | 5011092
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License Number State | NC
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