Provider Demographics
NPI:1386231884
Name:HUNTER, BRANDY NICOLE
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:NICOLE
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 1:548 CAMDEN AVE
Mailing Address - Street 2:
Mailing Address - City:MONONGAH
Mailing Address - State:WV
Mailing Address - Zip Code:26554-1105
Mailing Address - Country:US
Mailing Address - Phone:304-657-3402
Mailing Address - Fax:304-471-2488
Practice Address - Street 1:503 MORGANTOWN AVE
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-4388
Practice Address - Country:US
Practice Address - Phone:043-637-3753
Practice Address - Fax:304-363-7376
Is Sole Proprietor?:No
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker