Provider Demographics
NPI:1558427658
Name:HURLEY, MICHELE LORRAINE (PT)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:LORRAINE
Last Name:HURLEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7532 WILKINS DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-9338
Mailing Address - Country:US
Mailing Address - Phone:910-223-9023
Mailing Address - Fax:
Practice Address - Street 1:7532 WILKINS DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-9338
Practice Address - Country:US
Practice Address - Phone:910-868-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-31
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP9418225100000X
NC9418225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist