Provider Demographics
NPI:1578715082
Name:HUNTER, NAN D (LPN)
Entity Type:Individual
Prefix:MS
First Name:NAN
Middle Name:D
Last Name:HUNTER
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 1:113 N 19TH ST
Mailing Address - Street 2:
Mailing Address - City:WHEATLEY HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11798-1804
Mailing Address - Country:US
Mailing Address - Phone:917-402-8251
Mailing Address - Fax:
Practice Address - Street 1:113 NORTH 19TH STREET
Practice Address - Street 2:
Practice Address - City:WHEATLEY HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11798-2204
Practice Address - Country:US
Practice Address - Phone:917-402-8251
Practice Address - Fax:631-920-0332
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY250718-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse