Individual
NICHOLAS Q DE LA MOTTE HURST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1498 JESSE JEWELL PKWY SE STE A, GAINESVILLE, GA 30501-3874
(678) 257-2547
(404) 795-5832
Mailing address
3237 SATELLITE BLVD STE 425, DULUTH, GA 30096-9009
(678) 257-2547
(404) 795-5832
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
006327
GA
363AS0400X
Surgical Physician Assistant
53067
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
GA
Other
Enumeration date
11/09/2011
Last updated
12/11/2023
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