Provider Demographics
NPI:1407224470
Name:HURST, ELIZABETH (APRN)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:HURST
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 1:6200 DUTCHMANS LN STE 300
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-3271
Mailing Address - Country:US
Mailing Address - Phone:502-456-6200
Mailing Address - Fax:502-813-2660
Practice Address - Street 1:6200 DUTCHMANS LN STE 300
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-3271
Practice Address - Country:US
Practice Address - Phone:502-456-6200
Practice Address - Fax:502-813-2660
Is Sole Proprietor?:No
Enumeration Date:2015-09-09
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3009757363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily