Provider Demographics
NPI:1972757284
Name:HURST, LAURA ANN (MSN, CRNP)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:ANN
Last Name:HURST
Suffix:
Gender:F
Credentials:MSN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5600 CITY AVE
Mailing Address - Street 2:SAINT JOSEPH'S UNIVERSITY, STUDENT HEALTH CENTER
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-1308
Mailing Address - Country:US
Mailing Address - Phone:610-660-1175
Mailing Address - Fax:610-660-3378
Practice Address - Street 1:5600 CITY AVE
Practice Address - Street 2:SAINT JOSEPH'S UNIVERSITY, STUDENT HEALTH CENTER
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-1308
Practice Address - Country:US
Practice Address - Phone:610-660-1175
Practice Address - Fax:610-660-3378
Is Sole Proprietor?:No
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP001985C163WC1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1400XNursing Service ProvidersRegistered NurseCollege Health