MEDICARE: BRIDGET HURLEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	RN290264	GA

General Provider Information

NPI Number	:	1306592498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIDGET HURLEY

Provider Business Mailing Address
First Line	:	4078 TOWNSEND LN
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30346-1664
Country	:	US
Telephone Number	:	404-692-8248
Fax Number	:

Provider Business Practice Location Address
First Line	:	4078 TOWNSEND LN
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30346-1664
Country	:	US
Telephone Number	:	404-692-8248
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2022
Last Update Date	:	02/27/2022

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Directions to “ BRIDGET HURLEY ” Practice Location

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