Individual
DEQUILLA HURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
169 BERKLEY AVE, APT. C, LANSDOWNE, PA 19050-1332
(610) 246-0154
Mailing address
169 BERKLEY AVE, APT. C, LANSDOWNE, PA 19050-1332
(610) 246-0154
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
SP015396
PA
Other
Enumeration date
01/14/2016
Last updated
08/09/2021
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