Provider Demographics
NPI:1598112484
Name:HUNTER, LAOLA (RN)
Entity Type:Individual
Prefix:
First Name:LAOLA
Middle Name:
Last Name:HUNTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CHICK SPRINGS RD
Mailing Address - Street 2:SUITE 101 E
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29609-4946
Mailing Address - Country:US
Mailing Address - Phone:864-238-4315
Mailing Address - Fax:864-236-5917
Practice Address - Street 1:408 HUNTING CREEK DR
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-5778
Practice Address - Country:US
Practice Address - Phone:864-238-4315
Practice Address - Fax:864-236-5917
Is Sole Proprietor?:No
Enumeration Date:2016-05-20
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC64818163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management