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General NPI Number Information
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NPI Number | 1639488950
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Entity Type | Individual
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Provider Name | ROBERT KENNETH HURST NP-C
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Gender | Male
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Dates
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Enumeration Date | 10/04/2010
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Last Update Date | 08/14/2019
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Provider Practice Location Address
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Address Line | 617 E RIVERSIDE DR STE 302
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City | ST GEORGE
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State | UT
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Zip | 84790-8722
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Country | US
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Telephone | 435-652-6024
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Fax | 435-652-6025
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Provider Business Mailing Address
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Address Line | 230 N 1680 E STE I1
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City | ST GEORGE
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State | UT
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Zip | 84790-2586
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Country | US
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Telephone | 435-652-6024
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Fax | 435-652-6025
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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 | 6154039-4405
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License Number State | UT
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