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Susie Hurley

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

1021 Morehead Medical Dr, Ste A, Charlotte, NC 28204-2990

(980) 442-2000

PECOS Enrollment

Based on the most recent information from CMS, provider Susie Hurley is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:59 PM.

Profile Details

Provider ID
1154651008
Provider Type
Individual
Full Name
Hurley, Susie
Credential
FNP

Gender
Female
Sole Proprietor
No
Enumeration Date
12/28/2009
Last Updated
3/29/2021

Contact Information

Practice Location

1021 Morehead Medical Dr, Ste A, Charlotte, NC 28204-2990

(980) 442-2000

Unlisted Fax

Mailing Location

PO Box 19305, Charlotte, NC 28219-9305

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 5005194 North Carolina

Susie Hurley

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Pamperin, John William

Sullivan, Michael Daris

Calandra, Jennifer Ann

Heslop, Jaclyn Leigh

Mpofu, Fikile Sithembiso

Simmons, Maya

Thompson, Desirea'

Severeide, Jarrod Robert

Takon, Lovina;

Fowler, Abby Mcknight