| Doctor Name: | MR. JEREMY LEE HURST |
| NPI Number: | 1275816902 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RN, MSN, NP-C |
| License Number: | 23474-A |
| Business Practice Address: | 2501 Capehart Rd Offutt A F B, NE - 681131043 |
| Business Phone Number: | 4022946033 |
| Business Fax Number: | |
| Mailing Address: | 2501 Capehart Rd, OFFUTT A F B |
| State: | NE |
| Postal Code: | 681131043 |
| Phone Number: | 4022946033 |
| Fax Number: | |
| NPI Enumeration Date: | 09/20/2011 |
| NPI Last Update Date: | 03/11/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 23474-A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |