Individual
MRS. TONI LYNN HURLOCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
20172 N UMPQUA HWY, GLIDE, OR 97443-9620
(541) 496-0298
(541) 496-0703
Mailing address
PO BOX 458, GLIDE, OR 97443-0458
(541) 643-1638
(541) 496-0703
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201150169NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500697442
—
OR
Enumeration date
11/22/2011
Last updated
10/09/2019
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