Provider Demographics
NPI:1851621981
Name:HURLEY, NICOLE (MS,PT)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:HURLEY
Suffix:
Gender:F
Credentials:MS,PT
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:MARDANES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:110 HAVERHILL RD
Mailing Address - Street 2:SUITE 524
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-2123
Mailing Address - Country:US
Mailing Address - Phone:978-388-7272
Mailing Address - Fax:978-388-7373
Practice Address - Street 1:255 ROUTE 108
Practice Address - Street 2:SUITE 2
Practice Address - City:SOMERSWORTH
Practice Address - State:NH
Practice Address - Zip Code:03878-1543
Practice Address - Country:US
Practice Address - Phone:603-841-5441
Practice Address - Fax:603-841-5630
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8719225100000X
NH3594225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist