Provider Demographics
NPI:1265864680
Name:HURT, CAREY D (APRN)
Entity Type:Individual
Prefix:MRS
First Name:CAREY
Middle Name:D
Last Name:HURT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N PLUM ST
Mailing Address - Street 2:P.O. BOX 155
Mailing Address - City:MOLINE
Mailing Address - State:KS
Mailing Address - Zip Code:67353-9510
Mailing Address - Country:US
Mailing Address - Phone:620-647-8109
Mailing Address - Fax:620-647-3638
Practice Address - Street 1:200 N PLUM ST
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:KS
Practice Address - Zip Code:67353-9510
Practice Address - Country:US
Practice Address - Phone:620-647-8109
Practice Address - Fax:620-647-3638
Is Sole Proprietor?:No
Enumeration Date:2013-08-08
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-76097-072363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily