Individual
MR. JOE EARL HURD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4101 S 4TH ST, LEAVENWORTH, KS 66048-5014
(913) 682-2000
Mailing address
4101 S 4TH ST, LEAVENWORTH, KS 66048-5029
(913) 682-2000
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
1493816-052
KS
367500000X
Certified Registered Nurse Anesthetist
Primary
1493816-052
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
145062
BLUE CROSS BLUE SHIELD
KS
05
—
200270280A
—
KS
Enumeration date
05/06/2006
Last updated
11/12/2020
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