Provider Demographics
NPI:1689721805
Name:HUNTER, EDITH C (CRNA)
Entity Type:Individual
Prefix:
First Name:EDITH
Middle Name:C
Last Name:HUNTER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21544 CHICKACOAN TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:BROADLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:20148-5090
Mailing Address - Country:US
Mailing Address - Phone:703-858-1166
Mailing Address - Fax:
Practice Address - Street 1:10730 MAIN ST
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-3704
Practice Address - Country:US
Practice Address - Phone:703-691-0670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024152405367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered