Provider Demographics
NPI:1760786362
Name:HUNT, MICHAEL (CRNA, FNP, APRN)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:HUNT
Suffix:
Gender:M
Credentials:CRNA, FNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1161 S 1950 W
Mailing Address - Street 2:
Mailing Address - City:DELTA
Mailing Address - State:UT
Mailing Address - Zip Code:84624-7970
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1161 S 1950 W
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:UT
Practice Address - Zip Code:84624-7970
Practice Address - Country:US
Practice Address - Phone:208-525-2090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-23
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT351197-4405363LF0000X
AZAP9572363LF0000X
AZCRNA1353367500000X
IDRNA-815A367500000X
ID58241363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered