Provider Demographics
NPI:1770554644
Name:HURST, BARBARA (OGNP)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:HURST
Suffix:
Gender:F
Credentials:OGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 BRAEBURN DR
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-7357
Mailing Address - Country:US
Mailing Address - Phone:540-772-3520
Mailing Address - Fax:540-772-5975
Practice Address - Street 1:1802 BRAEBURN DR
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-7357
Practice Address - Country:US
Practice Address - Phone:540-772-3520
Practice Address - Fax:540-772-5975
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024064317363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007790813Medicaid
VAP00317048OtherMEDICARE RAILROAD
VA00W683L09Medicare ID - Type UnspecifiedRICHMOND MEDICARE
VA007790813Medicaid