Provider Demographics
NPI:1154181923
Name:HURT, KRISTEN MICHELLE (APRN)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:MICHELLE
Last Name:HURT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 418
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41702-0418
Mailing Address - Country:US
Mailing Address - Phone:606-233-4837
Mailing Address - Fax:
Practice Address - Street 1:200 MEDICAL CENTER DR STE 1A
Practice Address - Street 2:
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-9477
Practice Address - Country:US
Practice Address - Phone:606-439-5220
Practice Address - Fax:606-439-5221
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4017369363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100971290Medicaid