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Natalie Ann Civinelli Hurst

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

1915 White Ave, Knoxville, TN 37916-2300

PECOS Enrollment

This provider is enrolled in PECOS as NATALIE HURST.

Based on the most recent information from CMS, provider Natalie Ann Civinelli Hurst is legally eligible to order and refer claims for DME and PMD services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 11:00 AM.

Profile Details

Provider ID
1871145045
Provider Type
Individual
Full Name
Hurst, Natalie Ann Civinelli
Credential
MSN, ARPN, CCRN, FNP

Gender
Female
Sole Proprietor
No
Enumeration Date
7/9/2019
Last Updated
8/19/2019

Contact Information

Practice Location

1915 White Ave, Knoxville, TN 37916-2300

(865) 331-1720

Unlisted Fax

Mailing Location

1418 S Courtney Oak Ln, Knoxville, TN 37938-4481

(847) 421-7747

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 26074 Tennessee

Provider Identifiers

ID	Description	Issuer
ID Q051171	Description Medicaid	Issuer Unlisted Tennessee

Natalie Ann Civinelli Hurst

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

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Hairell, Ryan Keith

Harrill, Kaitlyn Dorthea

Haynes, Christy

Brumbach, Jennifer L

Williams, Alkiva Nicole

Huang, Jiajia

Stevens, Jenny R

Heidel, Wendy D

Burnette, Kristin