Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 0101052323 | VA |
N | 111NI0900X | Internist | 0101052323 | VA |
N | 207RC0000X | Internist - Cardiovascular Disease | 0101052323 | VA |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 0101052323 | VA |
NPI | 1255316485 |
---|---|
Provider Name | Denise L Hurst |
First Address | Alexandria, VA 22310-2541 |
Second Address | Alexandria, VA 22310 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2005 |
Last Update Date | 07/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G26599 | (02) | VA |