Provider Demographics
NPI:1801592712
Name:HURST, JENNY MARIE (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:MARIE
Last Name:HURST
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4308 BATTING ST NE
Mailing Address - Street 2:
Mailing Address - City:KEIZER
Mailing Address - State:OR
Mailing Address - Zip Code:97303-3912
Mailing Address - Country:US
Mailing Address - Phone:661-809-3817
Mailing Address - Fax:
Practice Address - Street 1:4308 BATTING ST NE
Practice Address - Street 2:
Practice Address - City:KEIZER
Practice Address - State:OR
Practice Address - Zip Code:97303-3912
Practice Address - Country:US
Practice Address - Phone:661-809-3817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-02
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200740371RN163W00000X
OR10018908363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse