Provider Demographics
NPI:1164436119
Name:HUNSINGER, GARY KENNETH JR (CNP)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:KENNETH
Last Name:HUNSINGER
Suffix:JR
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30055 NORTHWESTERN HWY STE 220
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3275
Mailing Address - Country:US
Mailing Address - Phone:248-865-9898
Mailing Address - Fax:248-865-9423
Practice Address - Street 1:30055 NORTHWESTERN HWY STE 220
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3275
Practice Address - Country:US
Practice Address - Phone:248-865-9898
Practice Address - Fax:248-865-9423
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704219053363L00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704219053OtherMI LICENSE
MI4704219053OtherMI LICENSE