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General NPI Number Information
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NPI Number | 1790452670
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Entity Type | Individual
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Provider Name | IALA TERESA HURST APRN
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Gender | Female
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Dates
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Enumeration Date | 08/27/2021
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Last Update Date | 03/09/2022
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Provider Practice Location Address
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Address Line | 13311 N 56TH ST
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City | TEMPLE TERRACE
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State | FL
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Zip | 33617-1161
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Country | US
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Telephone | 813-284-2220
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Fax | 813-377-1718
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Provider Business Mailing Address
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Address Line | 38135 MARKET SQ
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City | ZEPHYRHILLS
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State | FL
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Zip | 33542-7505
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Country | US
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Telephone | 813-284-2220
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Fax | 813-377-1718
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11014885
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License Number State | FL
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