Provider Demographics
NPI:1639848468
Name:HUNT, ANALISA DOMINIQUE (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ANALISA
Middle Name:DOMINIQUE
Last Name:HUNT
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:ANALISA
Other - Middle Name:DOMINIQUE
Other - Last Name:HERRERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16028 SUN SUMMIT PT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-2050
Mailing Address - Country:US
Mailing Address - Phone:512-574-7880
Mailing Address - Fax:
Practice Address - Street 1:9850 GENESEE AVE STE 710
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1218
Practice Address - Country:US
Practice Address - Phone:858-260-2977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-07
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0996903363LF0000X
CANP9501830363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily