Provider Demographics
NPI:1548232606
Name:HUNTER, JEFFREY (NP)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:HUNTER
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 PROFESSIONAL PL STE 145
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-8106
Mailing Address - Country:US
Mailing Address - Phone:719-428-5141
Mailing Address - Fax:719-212-6314
Practice Address - Street 1:2950 PROFESSIONAL PL STE 145
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-8106
Practice Address - Country:US
Practice Address - Phone:719-428-5141
Practice Address - Fax:719-212-6314
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN173147363LF0000X
CONP-5314363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO63200571Medicaid
CO63200571Medicaid