Individual
DEIRDEE HURST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
4121 KINGS CSWY, ELLENWOOD, GA 30294-1493
(404) 433-8809
Mailing address
4121 KINGS CSWY, ELLENWOOD, GA 30294-1493
(404) 433-8809
(678) 276-8198
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN-NP290644
GA
Other
Enumeration date
03/10/2023
Last updated
04/25/2026
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