Provider Demographics
NPI:1417157967
Name:CAROL L HUNTER, PC
Entity Type:Organization
Organization Name:CAROL L HUNTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:L
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:CNP
Authorized Official - Phone:505-974-0466
Mailing Address - Street 1:4655 CORRALES RD
Mailing Address - Street 2:C
Mailing Address - City:CORRALES
Mailing Address - State:NM
Mailing Address - Zip Code:87048-8617
Mailing Address - Country:US
Mailing Address - Phone:505-974-0466
Mailing Address - Fax:
Practice Address - Street 1:4655 CORRALES RD
Practice Address - Street 2:C
Practice Address - City:CORRALES
Practice Address - State:NM
Practice Address - Zip Code:87048-8617
Practice Address - Country:US
Practice Address - Phone:505-974-0466
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR21860364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Single Specialty