Individual
THERESA HURLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
4241 JOHNNY CAKE RIDGE RD, EAGAN, MN 55122-2235
(866) 389-2727
Mailing address
4241 JOHNNY CAKE RIDGE RD, EAGAN, MN 55122-2235
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F0714534
MN
363LF0000X
Family Nurse Practitioner
2660
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689077232
—
MN
Enumeration date
09/26/2014
Last updated
04/03/2024
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