Provider Demographics
NPI:1326652256
Name:HURST, AMY REBECCA (CNM)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:REBECCA
Last Name:HURST
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:REBECCA
Other - Last Name:TUTEWOHL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:14022 BELMONT CT
Mailing Address - Street 2:
Mailing Address - City:ROSEMOUNT
Mailing Address - State:MN
Mailing Address - Zip Code:55068-4978
Mailing Address - Country:US
Mailing Address - Phone:651-423-2076
Mailing Address - Fax:
Practice Address - Street 1:7920 OLD CEDAR AVE S
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55425-1207
Practice Address - Country:US
Practice Address - Phone:952-428-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN444176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife