Provider Demographics
NPI:1174816102
Name:HUNTER, NANCY LOUISE (FNP)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:LOUISE
Last Name:HUNTER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:NANCY
Other - Middle Name:LOUISE
Other - Last Name:KRENICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1951 N WILMOT RD,
Mailing Address - Street 2:BUILDING 1 STE. 2
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-8000
Mailing Address - Country:US
Mailing Address - Phone:520-722-3777
Mailing Address - Fax:520-296-6224
Practice Address - Street 1:5981 E GRANT RD
Practice Address - Street 2:STE. 115
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2363
Practice Address - Country:US
Practice Address - Phone:520-886-5315
Practice Address - Fax:520-298-8204
Is Sole Proprietor?:No
Enumeration Date:2011-05-24
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ105419363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZPENDINGMedicaid
AZPENDINGMedicaid