Provider Demographics
NPI:1609335090
Name:HURST MEDICAL PLLC
Entity Type:Organization
Organization Name:HURST MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:HURST
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:208-825-6193
Mailing Address - Street 1:1700 OVERLAND AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:BURLEY
Mailing Address - State:ID
Mailing Address - Zip Code:83318
Mailing Address - Country:US
Mailing Address - Phone:208-825-6193
Mailing Address - Fax:208-825-6199
Practice Address - Street 1:1700 OVERLAND AVE STE 1
Practice Address - Street 2:
Practice Address - City:BURLEY
Practice Address - State:ID
Practice Address - Zip Code:83318
Practice Address - Country:US
Practice Address - Phone:208-825-6193
Practice Address - Fax:208-825-6199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-15
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center