MEDICARE: MS. CHERYL E HURLBURT APRN/NP

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	RN58600AP3134	LA

General Provider Information

NPI Number	:	1467541516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHERYL E HURLBURT APRN/NP

Provider Business Mailing Address
First Line	:	507 HERMITAGE CT
Second Line	:
City	:	PEARL RIVER
State	:	LA
Zip	:	70452-3903
Country	:	US
Telephone Number	:	985-863-2828
Fax Number	:

Provider Business Practice Location Address
First Line	:	507 HERMITAGE CT
Second Line	:
City	:	PEARL RIVER
State	:	LA
Zip	:	70452-3903
Country	:	US
Telephone Number	:	985-863-2828
Fax Number	:

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

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	07/08/2007

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