MEDICARE: JENNIFER HURST DO

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	152W00000X	Optometrist	2025026318	MO

General Provider Information

NPI Number	:	1538042502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER HURST DO

Provider Business Mailing Address
First Line	:	477 HYDE PARK
Second Line	:
City	:	JACKSON
State	:	MO
Zip	:	63755-8725
Country	:	US
Telephone Number	:	618-993-5686
Fax Number	:	618-997-6250

Provider Business Practice Location Address
First Line	:	297 S SILVER SPRINGS RD
Second Line	:
City	:	CAPE GIRARDEAU
State	:	MO
Zip	:	63703-6309
Country	:	US
Telephone Number	:	573-651-5200
Fax Number	:

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

Provider Enumeration Date	:	07/28/2025
Last Update Date	:	04/15/2026

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