Individual provider Active NPI

Nancy a. Hurlock, AGPCNP-BC

  • Gerontology Nurse Practitioner
  • Statesboro, GA
National Provider Identifier
1245729300
Registry record updated Sep 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
2018002323 Issued in GA
Practice address
430 Northside Dr E Ste 160
Statesboro, GA 30458-4929
Phone
(912) 481-3003
NPI assigned
May 4, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 2018002323 GA Primary

Addresses

Primary practice location

430 Northside Dr E Ste 160
Statesboro, GA 30458-4929

Mailing address

2 University PLZ Ste 204
Hackensack, NJ 07601-6211
Phone (551) 295-8223

Other practice location 1

50 Glenlake Pkwy Ste 420
Sandy Springs, GA 30328-3489
Phone (551) 295-8223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190612000879 GA Practitioner - Nurse Practitioner 4880880335 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ennoble HC DMV LLCGroup PAC ID 9032517925, 112 clinicians

Practice addresses (Care Compare)

2002 Summit Blvd NE
Suite 300
Atlanta, GA 30319-1410
Phone (973) 241-1356

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2018002323GAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ennoble HC DMV III LLC CurrentSince Nov 2, 2025 Accepting new patients
Ennoble HC DMV II LLC CurrentSince Nov 2, 2025 Accepting new patients
Ennoble HC DMV LLC CurrentSince Nov 11, 2024 Accepting new patients
Above & Beyond Healthcare Services, LLC CurrentSince Mar 1, 2019 Accepting new patients

Locations

2002 Summit Blvd
Ste 300
Brookhaven, GA 30319
Phone (973) 241-1356

50 Glenlake Pkwy
Ste 420
Sandy Springs, GA 30328
Phone (404) 595-2210

62 E Main St
Statesboro, GA 30458
Phone (912) 225-3220

430 Northside Dr E
Ste 160
Statesboro, GA 30458
Phone (478) 494-0421

2 University Plz
Ste 204
Hackensack, NJ 07601
Phone (201) 564-0142

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1525392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757721600000",
    "number": "1245729300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 UNIVERSITY PLZ STE 204",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076016211",
            "telephone_number": "551-295-8223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 NORTHSIDE DR E STE 160",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304584929",
            "telephone_number": "912-481-3003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Glenlake Pkwy Ste 420",
            "address_purpose": "LOCATION",
            "city": "Sandy Springs",
            "state": "GA",
            "postal_code": "303283489",
            "country_code": "US",
            "telephone_number": "551-295-8223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HURLOCK",
        "first_name": "NANCY A.",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-04",
        "last_updated": "2025-09-13",
        "certification_date": "2025-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "2018002323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

Verify at the official NPI Registry.