Basic Information
| Provider Information | |||||||||
| NPI: | 1043964497 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HURTADO PEREZ | ||||||||
| FirstName: | JORGE | ||||||||
| MiddleName: | IGNACIO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1619 GLENHAVEN DR | ||||||||
| Address2: | |||||||||
| City: | MURFREESBORO | ||||||||
| State: | TN | ||||||||
| PostalCode: | 371305619 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158159792 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1211 MEDICAL CENTER DR | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372320004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153225000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/04/2022 | ||||||||
| LastUpdateDate: | 02/04/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WC0200X | 0000232345 | TN | Y | Nursing Service Providers | Registered Nurse | Critical Care Medicine |
No ID Information.