Provider Demographics
NPI:1639488950
Name:HURST, ROBERT KENNETH (NP-C)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:KENNETH
Last Name:HURST
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 N 1680 E STE I1
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-2586
Mailing Address - Country:US
Mailing Address - Phone:435-652-6024
Mailing Address - Fax:435-652-6025
Practice Address - Street 1:617 E RIVERSIDE DR STE 302
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-8722
Practice Address - Country:US
Practice Address - Phone:435-652-6024
Practice Address - Fax:435-652-6025
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6154039-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily