Provider Demographics
NPI:1881172179
Name:HURLEY, STEPHANIE NICHOLE (CMA, CPT)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:NICHOLE
Last Name:HURLEY
Suffix:
Gender:F
Credentials:CMA, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 HELENA ST
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47006-1401
Mailing Address - Country:US
Mailing Address - Phone:812-527-7289
Mailing Address - Fax:
Practice Address - Street 1:3009 BURNET AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2419
Practice Address - Country:US
Practice Address - Phone:513-872-8870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-30
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INL9M6E8N3246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy