Provider Demographics
NPI:1447917935
Name:HURST, ROBIN RENEE
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:RENEE
Last Name:HURST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N2032 BONNIE LN
Mailing Address - Street 2:
Mailing Address - City:MARINETTE
Mailing Address - State:WI
Mailing Address - Zip Code:54143-9469
Mailing Address - Country:US
Mailing Address - Phone:434-825-8642
Mailing Address - Fax:
Practice Address - Street 1:FLORENCE HEALTH SERVICES
Practice Address - Street 2:5778 CHAPIN ST
Practice Address - City:FLORENCE
Practice Address - State:WI
Practice Address - Zip Code:54121
Practice Address - Country:US
Practice Address - Phone:715-528-4833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501020071225100000X
VA2305004352225100000X
WI15646-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist