Provider Demographics
NPI:1598218950
Name:HURST, ERIN (MS, RDN, LD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:HURST
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59741 TYHOLLAND LN
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46544-9715
Mailing Address - Country:US
Mailing Address - Phone:574-440-8700
Mailing Address - Fax:574-440-8701
Practice Address - Street 1:6910 N MAIN ST UNIT 24A
Practice Address - Street 2:
Practice Address - City:GRANGER
Practice Address - State:IN
Practice Address - Zip Code:46530-8845
Practice Address - Country:US
Practice Address - Phone:574-440-8700
Practice Address - Fax:574-440-8701
Is Sole Proprietor?:No
Enumeration Date:2016-08-02
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN37002369A133V00000X
133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered