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NPI Code Detail

MEDICARE: CARL DOUGLAS HURD PMHNP

MEDICARE: CARL DOUGLAS HURD PMHNP
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
1363L00000XNurse Practitioner5014813NC
2363LP0808XPsychiatric/Mental Health Nurse Practitioner5014813NC

General Provider Information

NPI Number : 1346914256
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARL DOUGLAS HURD PMHNP
Provider Business Mailing Address
First Line : 3555 HANSA DR
Second Line :
City : CASTLE HAYNE
State : NC
Zip : 28429-5863
Country : US
Telephone Number : 706-830-0277
Fax Number :
Provider Business Practice Location Address
First Line : 14057 US HIGHWAY 17 STE 200
Second Line :
City : HAMPSTEAD
State : NC
Zip : 28443-3793
Country : US
Telephone Number : 910-821-1418
Fax Number : 866-860-0997
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2021
Last Update Date : 01/02/2023

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