Provider Demographics
NPI:1265618839
Name:HURD, ANITA LYNN (REGISTERED NURSE)
Entity type:Individual
Prefix:MS
First Name:ANITA
Middle Name:LYNN
Last Name:HURD
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 WAVERELY OAKS ROAD
Mailing Address - Street 2:BUILDING #3, SUITE 305
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02452
Mailing Address - Country:US
Mailing Address - Phone:781-894-6564
Mailing Address - Fax:
Practice Address - Street 1:411 WAVERELY OAKS ROAD
Practice Address - Street 2:BUILDING #3, SUITE 305
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02452
Practice Address - Country:US
Practice Address - Phone:781-894-6564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA00000000000000000000163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse