Provider Demographics
NPI:1487759783
Name:HURT, LINDA M (AU D)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:HURT
Suffix:
Gender:F
Credentials:AU D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2917 INDEPENDENCE ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63703-5025
Mailing Address - Country:US
Mailing Address - Phone:573-651-4650
Mailing Address - Fax:573-651-5212
Practice Address - Street 1:2917 INDEPENDENCE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-5025
Practice Address - Country:US
Practice Address - Phone:573-651-4650
Practice Address - Fax:573-651-5212
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01354231H00000X
MO000604237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO469802OtherHEALTHLINK
MO126806OtherABCBS