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NPI 1679744296

NPI 1679744296 : TIERRA R HURD PA : NATIONAL HARBOR, MD

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General NPI Number Information
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    NPI Number           |    1679744296
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    Entity Type          |    Individual 
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    Provider Name        |    TIERRA R HURD PA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/24/2008
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    Last Update Date     |    06/10/2025
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Provider Practice Location Address
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    Address Line         |    174 WATERFRONT ST STE 200 
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    City                 |    NATIONAL HARBOR
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    State                |    MD
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    Zip                  |    20745-1164
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    Country              |    US
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    Telephone            |    240-493-8447
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6201 GREENLEIGH AVE 
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    City                 |    MIDDLE RIVER
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    State                |    MD
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    Zip                  |    21220-2004
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    Country              |    US
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    Telephone            |    410-933-2704
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    Fax                  |    410-500-4266
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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        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    C08905
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    License Number State |    MD
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