Provider Demographics
NPI:1003673468
Name:HUNTER, TRINA S (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:TRINA
Middle Name:S
Last Name:HUNTER
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:TRINA
Other - Middle Name:S
Other - Last Name:BOWLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, IBCLC
Mailing Address - Street 1:8601 W EMERALD ST STE 160
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-8297
Mailing Address - Country:US
Mailing Address - Phone:208-991-4488
Mailing Address - Fax:
Practice Address - Street 1:8601 W EMERALD ST STE 160
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-8297
Practice Address - Country:US
Practice Address - Phone:208-991-4488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDL-88978163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant