Provider Demographics
NPI:1972264182
Name:HURLEY, TINA MARIA (RN, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:TINA
Middle Name:MARIA
Last Name:HURLEY
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 BAYOU FOLSE RD
Mailing Address - Street 2:
Mailing Address - City:RACELAND
Mailing Address - State:LA
Mailing Address - Zip Code:70394-3728
Mailing Address - Country:US
Mailing Address - Phone:985-217-8088
Mailing Address - Fax:
Practice Address - Street 1:520 BAYOU FOLSE RD
Practice Address - Street 2:
Practice Address - City:RACELAND
Practice Address - State:LA
Practice Address - Zip Code:70394-3728
Practice Address - Country:US
Practice Address - Phone:985-217-8088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-10
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA214224163WS0200X
LAL-309149163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163WS0200XNursing Service ProvidersRegistered NurseSchool