Provider Demographics
NPI:1205332368
Name:HUNT, JOANNA MAE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:MAE
Last Name:HUNT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1045
Mailing Address - Street 2:
Mailing Address - City:PHENIX CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36868-1045
Mailing Address - Country:US
Mailing Address - Phone:334-291-5255
Mailing Address - Fax:887-395-0710
Practice Address - Street 1:5060 N 19TH AVE STE 102
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-3211
Practice Address - Country:US
Practice Address - Phone:602-296-5540
Practice Address - Fax:602-296-5442
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-113269207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1-113269OtherALABAMA BOARD OF NURSING
AZ223081OtherNP STATE LICENSE