Provider Demographics
NPI:1801592712
Name:HURST, JENNY MARIE (FAMILY NURSE PRACTIT)
Entity type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:MARIE
Last Name:HURST
Suffix:
Gender:F
Credentials:FAMILY NURSE PRACTIT
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Mailing Address - Street 1:11209 N TATUM BLVD #180
Mailing Address - Street 2:PARADISE VALLEY FAMILY MEDICINE
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028
Mailing Address - Country:US
Mailing Address - Phone:602-494-5155
Mailing Address - Fax:602-494-5115
Practice Address - Street 1:11209 N TATUM BLVD #180
Practice Address - Street 2:PARADISE VALLEY FAMILY MEDICINE
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028
Practice Address - Country:US
Practice Address - Phone:602-494-5155
Practice Address - Fax:602-494-5115
Is Sole Proprietor?:No
Enumeration Date:2023-02-02
Last Update Date:2025-06-17
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Provider Licenses
StateLicense IDTaxonomies
OR10018908363LF0000X
OR200740371RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse