Individual
JACK HURRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, PMHNP-BC
Contact information
Practice address
801 PENNSYLVANIA AVE SE, WASHINGTON, DC 20003-2167
(202) 546-1512
(202) 544-5365
Mailing address
801 PENNSYLVANIA AVE SE, WASHINGTON, DC 20003-2167
(202) 546-1512
(202) 544-5365
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
163W00000X
Registered Nurse
847545
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95003902
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/22/2011
Last updated
07/21/2022
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