Provider Demographics
NPI:1033635396
Name:HURST, EMILY NICOLE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:NICOLE
Last Name:HURST
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 CHAPEN WAY
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:AR
Mailing Address - Zip Code:72921-8502
Mailing Address - Country:US
Mailing Address - Phone:479-462-9135
Mailing Address - Fax:
Practice Address - Street 1:816 FAYETTEVILLE RD
Practice Address - Street 2:
Practice Address - City:VAN BUREN
Practice Address - State:AR
Practice Address - Zip Code:72956-3423
Practice Address - Country:US
Practice Address - Phone:268-294-9479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-18
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP9195235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist