Provider Demographics
NPI:1902884794
Name:HURD, LINDA A (CRNP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:A
Last Name:HURD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3624 MARKET STREET
Mailing Address - Street 2:SUITE 560 W
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-2617
Mailing Address - Country:US
Mailing Address - Phone:215-662-3958
Mailing Address - Fax:609-463-0957
Practice Address - Street 1:1400 ROUTE 70 EAST
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2240
Practice Address - Country:US
Practice Address - Phone:856-216-0300
Practice Address - Fax:609-463-0957
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN05844200363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ052337Medicare PIN
NJ439121Medicare PIN
P43267Medicare UPIN