Provider Demographics
NPI:1003476144
Name:HUNTER, KANDICE NICOLE (APRN, AGNP)
Entity Type:Individual
Prefix:MISS
First Name:KANDICE
Middle Name:NICOLE
Last Name:HUNTER
Suffix:
Gender:F
Credentials:APRN, AGNP
Other - Prefix:
Other - First Name:KANDICE
Other - Middle Name:NICOLE
Other - Last Name:JOHNSON-HUNTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:116 SAVANNAH ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71202-3922
Mailing Address - Country:US
Mailing Address - Phone:318-537-3056
Mailing Address - Fax:
Practice Address - Street 1:4864 JACKSON ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71202-6400
Practice Address - Country:US
Practice Address - Phone:318-330-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-20
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA206498363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner