Carlin Brae Hurst, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP140364 Issued in TX

Practice address

20783 Interstate 20 S Access Rd
Canton, TX 75103-3573

Phone

(903) 567-5437

Fax

(844) 678-6258

NPI assigned

Jan 28, 2019

Last updated

Jul 19, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Carlin Blanchard-Blackburn Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carlinhurstfnp@foreverkidspediatricclinic.ssdirect.aprima.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Forever Kids Pediatric Clinic

  • Clinic/Center
  • Canton, TX
  • NPI 1326435199
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1548633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1174087704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20783 INTERSTATE 20 S ACCESS RD",
            "city": "CANTON",
            "state": "TX",
            "postal_code": "751033573",
            "telephone_number": "402-598-5089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20783 INTERSTATE 20 S ACCESS RD",
            "city": "CANTON",
            "state": "TX",
            "postal_code": "751033573",
            "telephone_number": "903-567-5437",
            "fax_number": "844-678-6258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURST",
        "first_name": "CARLIN",
        "middle_name": "BRAE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-28",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP140364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLIN",
            "last_name": "BLANCHARD-BLACKBURN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Kristofer Todd Ingram, D.C.
• Tina Michelle Ingram, DC, FNP-C, DIPL.AC
• JL Miguez Inc Dba Newsound Hearing Centers (JL Miguez Inc dba Hear Life Hearing Care)

• Family Nurse Practitioner in Canton, TX
• Providers in Canton, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.