Provider Demographics
NPI:1710571088
Name:HURDLE, NAKEA (JD)
Entity Type:Individual
Prefix:MISS
First Name:NAKEA
Middle Name:
Last Name:HURDLE
Suffix:
Gender:F
Credentials:JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 WAKELING ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19124-2637
Mailing Address - Country:US
Mailing Address - Phone:267-304-7679
Mailing Address - Fax:
Practice Address - Street 1:1301 WAKELING ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19124-2637
Practice Address - Country:US
Practice Address - Phone:267-304-7679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-26
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA47153601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health