Provider Demographics
NPI:1033470638
Name:HURTLEY, KARLA LYNN (PNP)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:LYNN
Last Name:HURTLEY
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1165 ARCADE ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55106-2615
Mailing Address - Country:US
Mailing Address - Phone:651-772-5561
Mailing Address - Fax:651-772-5566
Practice Address - Street 1:CHILDREN'S HEALTH CARE
Practice Address - Street 2:345 NORTH SMITH AVE
Practice Address - City:ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102
Practice Address - Country:US
Practice Address - Phone:651-220-6750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-31
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 203782 2363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics