Provider Demographics
NPI:1235813049
Name:HUNTER, THERESA ANNE
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:ANNE
Last Name:HUNTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3176 N JOG RD APT 7201
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-7428
Mailing Address - Country:US
Mailing Address - Phone:561-628-8675
Mailing Address - Fax:
Practice Address - Street 1:3176 N JOG RD APT 7201
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-7428
Practice Address - Country:US
Practice Address - Phone:561-628-8675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL148138251E00000X, 251G00000X, 314000000X, 261QP2400X, 282E00000X, 3104A0625X, 311500000X, 324500000X, 376K00000X, 310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No261QP2400XAmbulatory Health Care FacilitiesClinic/CenterPrison Health
No282E00000XHospitalsLong Term Care Hospital
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No376K00000XNursing Service Related ProvidersNurse's Aide