Provider Demographics
NPI:1467201673
Name:HURDLE, NATASHA (OTR/L)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:HURDLE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:NATASHA
Other - Middle Name:
Other - Last Name:HURDLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L
Mailing Address - Street 1:6672 WHITE BLOSSOM CIR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-8422
Mailing Address - Country:US
Mailing Address - Phone:904-239-6077
Mailing Address - Fax:
Practice Address - Street 1:9905 OLD SAINT AUGUSTINE RD STE 503
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-8856
Practice Address - Country:US
Practice Address - Phone:904-448-1025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-20
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
FL12082225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist