Provider Demographics
NPI:1205969946
Name:HUNCHUCK, MILLICENT (CRNP)
Entity type:Individual
Prefix:
First Name:MILLICENT
Middle Name:
Last Name:HUNCHUCK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 SIMPSON RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:BROWNSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15417-9689
Mailing Address - Country:US
Mailing Address - Phone:724-785-9444
Mailing Address - Fax:724-785-9458
Practice Address - Street 1:129 SIMPSON RD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15417-9689
Practice Address - Country:US
Practice Address - Phone:724-785-9444
Practice Address - Fax:724-785-4911
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP006876B363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA047260Medicare ID - Type Unspecified
PAP30073Medicare UPIN