Provider Demographics
NPI:1801422084
Name:HURST, STEPHANIE
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:HURST
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 1:6749 E BROOKS DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85730-1629
Mailing Address - Country:US
Mailing Address - Phone:502-230-9633
Mailing Address - Fax:
Practice Address - Street 1:4010 DUPONT CIR STE 419
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4837
Practice Address - Country:US
Practice Address - Phone:502-230-9633
Practice Address - Fax:502-230-9633
Is Sole Proprietor?:No
Enumeration Date:2020-03-19
Last Update Date:2023-05-05
Deactivation Date:2023-04-16
Deactivation Code:
Reactivation Date:2023-05-03
Provider Licenses
StateLicense IDTaxonomies
KY2546931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1720774375OtherORGANIZATION NPI (NUAURA SOLUTIONS, LLC)