Provider Demographics
NPI:1386517134
Name:HURT, ROBIN
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:HURT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:561 SANDY RIDGE CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:ELLERBE
Mailing Address - State:NC
Mailing Address - Zip Code:28338-9170
Mailing Address - Country:US
Mailing Address - Phone:937-309-9537
Mailing Address - Fax:
Practice Address - Street 1:561 SANDY RIDGE CHURCH RD
Practice Address - Street 2:
Practice Address - City:ELLERBE
Practice Address - State:NC
Practice Address - Zip Code:28338-9170
Practice Address - Country:US
Practice Address - Phone:937-309-9537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-27
Last Update Date:2025-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC000047149826343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)