Provider Demographics
NPI:1447561931
Name:HURST, DEBORAH MARIE (CNS)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:MARIE
Last Name:HURST
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 N MAIN ST
Mailing Address - Street 2:SUITE 1360
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45423-1021
Mailing Address - Country:US
Mailing Address - Phone:937-252-2003
Mailing Address - Fax:888-965-4549
Practice Address - Street 1:40 N MAIN ST
Practice Address - Street 2:SUITE 1360
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45423-1021
Practice Address - Country:US
Practice Address - Phone:937-252-2003
Practice Address - Fax:888-965-4549
Is Sole Proprietor?:No
Enumeration Date:2010-06-29
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH260288163W00000X
OHCOA.11289-NS364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0081675Medicaid
OHH174210Medicare PIN