Provider Demographics
NPI:1538936638
Name:HURST, RANSLAH (LPN)
Entity type:Individual
Prefix:
First Name:RANSLAH
Middle Name:
Last Name:HURST
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10075 GATE PKWY N
Mailing Address - Street 2:1101
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246-4435
Mailing Address - Country:US
Mailing Address - Phone:478-550-4089
Mailing Address - Fax:
Practice Address - Street 1:4237 SALISBURY RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-8029
Practice Address - Country:US
Practice Address - Phone:904-749-4492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-08
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5240422164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse