| Doctor Name: | DEQUILLA HURT |
| NPI Number: | 1063878411 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | SPO15396 |
| Business Practice Address: | 169 Berkley Ave Apt. C Lansdowne, PA - 190501332 |
| Business Phone Number: | 6102460154 |
| Business Fax Number: | |
| Mailing Address: | 169 Berkley Ave, Apt. C LANSDOWNE |
| State: | PA |
| Postal Code: | 190501332 |
| Phone Number: | 6102460154 |
| Fax Number: | |
| NPI Enumeration Date: | 01/14/2016 |
| NPI Last Update Date: | 01/14/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WG0600X |
| License Number: | SPO15396 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |