Provider Demographics
NPI:1760745228
Name:HUNT, ERIKA J (PA)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:J
Last Name:HUNT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:J
Other - Last Name:KOSMATKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 6002
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58206-6002
Mailing Address - Country:US
Mailing Address - Phone:701-780-5000
Mailing Address - Fax:701-780-1899
Practice Address - Street 1:1200 S COLUMBIA RD
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-4036
Practice Address - Country:US
Practice Address - Phone:701-780-6000
Practice Address - Fax:701-780-5772
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDPAC0485363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDN717799Medicare PIN