Provider Demographics
NPI:1659559276
Name:HURLEY, PATRICK SCOTT (PA)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:SCOTT
Last Name:HURLEY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 843298
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02284-3298
Mailing Address - Country:US
Mailing Address - Phone:910-878-5100
Mailing Address - Fax:910-878-5140
Practice Address - Street 1:6322 FAYETTEVILLE ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-7998
Practice Address - Country:US
Practice Address - Phone:910-878-5100
Practice Address - Fax:910-878-5140
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-01238363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical