Provider Demographics
NPI:1821488495
Name:HUNTER, KERI A (PA-C)
Entity Type:Individual
Prefix:
First Name:KERI
Middle Name:A
Last Name:HUNTER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KERI
Other - Middle Name:A
Other - Last Name:BOLTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:603 7TH STREET SOUTH
Mailing Address - Street 2:SUITE 500
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4734
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:603 7TH STREET SOUTH
Practice Address - Street 2:SUITE 500
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4734
Practice Address - Country:US
Practice Address - Phone:727-893-6667
Practice Address - Fax:727-553-7158
Is Sole Proprietor?:No
Enumeration Date:2015-02-03
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA008215363A00000X
FLPA9108464363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant