Provider Demographics
NPI:1831748789
Name:HURST, TRISH (FNP-C)
Entity type:Individual
Prefix:
First Name:TRISH
Middle Name:
Last Name:HURST
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 SHIRLEY RD
Mailing Address - Street 2:
Mailing Address - City:WASHBURN
Mailing Address - State:TN
Mailing Address - Zip Code:37888-4434
Mailing Address - Country:US
Mailing Address - Phone:865-556-2919
Mailing Address - Fax:
Practice Address - Street 1:833 SHIRLEY RD
Practice Address - Street 2:
Practice Address - City:WASHBURN
Practice Address - State:TN
Practice Address - Zip Code:37888-4434
Practice Address - Country:US
Practice Address - Phone:865-556-2919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26383207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine