Basic Information
| Provider Information | |||||||||
| NPI: | 1275991663 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HURST | ||||||||
| FirstName: | TIMOTHY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 286 HUGHES RD | ||||||||
| Address2: | |||||||||
| City: | ALBANY | ||||||||
| State: | KY | ||||||||
| PostalCode: | 426026641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6063870680 | ||||||||
| FaxNumber: | 6159881635 | ||||||||
| Practice Location | |||||||||
| Address1: | 1211 MEDICAL CENTER DR | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372321090 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6159360770 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2016 | ||||||||
| LastUpdateDate: | 10/23/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP143110 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | 3010057 | KY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.