Provider Demographics
NPI:1639839293
Name:HURST, NATALIE J (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:J
Last Name:HURST
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13209 MOUNTAIN SHADOW RD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-5529
Mailing Address - Country:US
Mailing Address - Phone:505-948-3462
Mailing Address - Fax:
Practice Address - Street 1:13209 MOUNTAIN SHADOW RD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-5529
Practice Address - Country:US
Practice Address - Phone:505-948-3462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-23
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMSLP5025235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist