Provider Demographics
NPI:1922582709
Name:HUNTER, BRYAN (LPN)
Entity Type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:
Last Name:HUNTER
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 S PATTEN RD
Mailing Address - Street 2:
Mailing Address - City:PATTEN
Mailing Address - State:ME
Mailing Address - Zip Code:04765-3007
Mailing Address - Country:US
Mailing Address - Phone:866-366-5842
Mailing Address - Fax:
Practice Address - Street 1:180 MAIN RD # ME04414
Practice Address - Street 2:
Practice Address - City:BROWNVILLE
Practice Address - State:ME
Practice Address - Zip Code:04414-3107
Practice Address - Country:US
Practice Address - Phone:866-366-5842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELPN13078164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse