Provider Demographics
NPI:1457839268
Name:HUNT, CHRISTY NICOLE
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:NICOLE
Last Name:HUNT
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 1:215 MARCLIFF CT
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30349-4993
Mailing Address - Country:US
Mailing Address - Phone:770-490-6682
Mailing Address - Fax:
Practice Address - Street 1:835 MARTIN LUTHER KING JR DR NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30314-3644
Practice Address - Country:US
Practice Address - Phone:404-460-2706
Practice Address - Fax:404-460-2707
Is Sole Proprietor?:No
Enumeration Date:2018-08-02
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH026441183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist