Provider Demographics
NPI:1467741777
Name:HUNT, MAUDNEL (LPN)
Entity Type:Individual
Prefix:MISS
First Name:MAUDNEL
Middle Name:
Last Name:HUNT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:542 CENTRAL AVE
Mailing Address - Street 2:PH
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11221-5220
Mailing Address - Country:US
Mailing Address - Phone:347-231-7628
Mailing Address - Fax:
Practice Address - Street 1:542 CENTRAL AVE
Practice Address - Street 2:PH
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11221-5220
Practice Address - Country:US
Practice Address - Phone:347-231-7628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY242627-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse