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General NPI Number Information
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NPI Number | 1538553060
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Entity Type | Individual
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Provider Name | KATHRYN NICOLE HURST MD
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Gender | Female
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Dates
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Enumeration Date | 03/23/2015
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 1577 COMMERCIAL STREET FL 2
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City | PORTLAND
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State | ME
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Zip | 04102
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Country | US
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Telephone | 207-662-5790
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Fax |
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Provider Business Mailing Address
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Address Line | 1577 CONGRESS ST
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City | PORTLAND
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State | ME
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Zip | 04102-2169
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Country | US
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Telephone | 207-662-5522
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Fax | 207-774-1814
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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 | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number | MT215535
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number | MD24761
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License Number State | ME
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