Individual
DR. GLENN EDWARD HURST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 RIDGE ST STE 201, COUNCIL BLUFFS, IA 51503-4643
(712) 322-5899
Mailing address
PO BOX 306, MINDEN, IA 51553-0306
(712) 407-2086
(712) 407-2087
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5360
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38242
IOWA BOARD OF MEDICINE
IA
01
—
5360
NE STATE LISCENSE NUMBER
NE
Enumeration date
06/18/2008
Last updated
03/07/2023
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