Provider Demographics
NPI:1508159906
Name:HURST, CARLENE (RN, MSN, CDE)
Entity Type:Individual
Prefix:
First Name:CARLENE
Middle Name:
Last Name:HURST
Suffix:
Gender:F
Credentials:RN, MSN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 S MAIN ST
Mailing Address - Street 2:STE 2
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-2917
Mailing Address - Country:US
Mailing Address - Phone:575-636-5365
Mailing Address - Fax:575-524-1454
Practice Address - Street 1:1100 S MAIN ST
Practice Address - Street 2:STE 2
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-2917
Practice Address - Country:US
Practice Address - Phone:575-636-5365
Practice Address - Fax:575-524-1454
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-18
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRN-71282163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator