Provider Demographics
NPI:1083488688
Name:HURT, JASMINE IVY (RN, MSN)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:IVY
Last Name:HURT
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2053 E CHELTEN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19138-3043
Mailing Address - Country:US
Mailing Address - Phone:267-205-4610
Mailing Address - Fax:
Practice Address - Street 1:15 S 3RD ST FL 5
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19106-2848
Practice Address - Country:US
Practice Address - Phone:215-732-5050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR19650600163W00000X
PARN678522163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse