Provider Demographics
NPI:1205587854
Name:MICHAEL, HUNTER SCOTT (RN,MSN, APRN, FNP-BC)
Entity type:Individual
Prefix:MR
First Name:HUNTER
Middle Name:SCOTT
Last Name:MICHAEL
Suffix:
Gender:M
Credentials:RN,MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 COUNTY ROAD 312
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834-6886
Mailing Address - Country:US
Mailing Address - Phone:662-808-3474
Mailing Address - Fax:
Practice Address - Street 1:1115 N 2ND ST
Practice Address - Street 2:
Practice Address - City:BOONEVILLE
Practice Address - State:MS
Practice Address - Zip Code:38829-1021
Practice Address - Country:US
Practice Address - Phone:662-480-4141
Practice Address - Fax:662-796-5275
Is Sole Proprietor?:No
Enumeration Date:2022-01-14
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS905094363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care