Provider Demographics
NPI:1407472210
Name:FARTHING, HUNTER (MS, RDN, LDN)
Entity Type:Individual
Prefix:
First Name:HUNTER
Middle Name:
Last Name:FARTHING
Suffix:
Gender:F
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 20126
Mailing Address - Street 2:
Mailing Address - City:ST SIMONS IS
Mailing Address - State:GA
Mailing Address - Zip Code:31522-8126
Mailing Address - Country:US
Mailing Address - Phone:217-549-8190
Mailing Address - Fax:
Practice Address - Street 1:1704 FREDERICA RD APT 436
Practice Address - Street 2:
Practice Address - City:ST SIMONS IS
Practice Address - State:GA
Practice Address - Zip Code:31522-2559
Practice Address - Country:US
Practice Address - Phone:478-239-0865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-18
Last Update Date:2023-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164.007717133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered