Provider Demographics
NPI:1386253730
Name:HURT, NATOSHA
Entity type:Individual
Prefix:
First Name:NATOSHA
Middle Name:
Last Name:HURT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 OSBORNE ST
Mailing Address - Street 2:
Mailing Address - City:KEYSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23947-3648
Mailing Address - Country:US
Mailing Address - Phone:434-390-1733
Mailing Address - Fax:
Practice Address - Street 1:27728 PRINCE EDWARD HWY
Practice Address - Street 2:
Practice Address - City:RICE
Practice Address - State:VA
Practice Address - Zip Code:23966-2702
Practice Address - Country:US
Practice Address - Phone:434-390-1733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider