Provider Demographics
NPI:1124574876
Name:CHRISTINE J HURD
Entity Type:Organization
Organization Name:CHRISTINE J HURD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:HURD
Authorized Official - Suffix:
Authorized Official - Credentials:O,T,R
Authorized Official - Phone:479-530-2979
Mailing Address - Street 1:27210 SOUTH HWY 125
Mailing Address - Street 2:MONKEY ISLAND
Mailing Address - City:AFTON
Mailing Address - State:OK
Mailing Address - Zip Code:74331
Mailing Address - Country:US
Mailing Address - Phone:479-530-2979
Mailing Address - Fax:
Practice Address - Street 1:1401 NORTH LELIA STREET
Practice Address - Street 2:
Practice Address - City:GUYMON
Practice Address - State:OK
Practice Address - Zip Code:73942
Practice Address - Country:US
Practice Address - Phone:580-338-3186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1892314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility