Provider Demographics
NPI:1447705132
Name:HURST, CHRISTINA LEE (FNP-C)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LEE
Last Name:HURST
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:LISBON
Mailing Address - State:OH
Mailing Address - Zip Code:44432-1014
Mailing Address - Country:US
Mailing Address - Phone:330-424-9866
Mailing Address - Fax:330-424-7689
Practice Address - Street 1:400 N MARKET ST
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:OH
Practice Address - Zip Code:44432-1014
Practice Address - Country:US
Practice Address - Phone:330-424-9866
Practice Address - Fax:330-424-7689
Is Sole Proprietor?:No
Enumeration Date:2016-08-23
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF0616550363LF0000X
OHAPRN.CNP.019338363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily