Provider Demographics
NPI:1639825144
Name:HUNT, MIRANDA FRANCINE (PA-C)
Entity Type:Individual
Prefix:
First Name:MIRANDA
Middle Name:FRANCINE
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 1:1624 WESTOWN WAY
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-9623
Mailing Address - Country:US
Mailing Address - Phone:302-242-9544
Mailing Address - Fax:
Practice Address - Street 1:4745 OGLETOWN STANTON RD STE 134
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2074
Practice Address - Country:US
Practice Address - Phone:302-738-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant