Provider Demographics
NPI:1558669820
Name:HUNT, EMILY SIMMONS (PA-C)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:SIMMONS
Last Name:HUNT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 PENN AVE
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-1306
Mailing Address - Country:US
Mailing Address - Phone:507-398-8197
Mailing Address - Fax:
Practice Address - Street 1:1140 PENN AVE
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-1306
Practice Address - Country:US
Practice Address - Phone:507-398-8197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-10
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110003553363A00000X
CAPA22337363A00000X
AZ4836363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant