Provider Demographics
NPI:1265434872
Name:HITE, JUNE MARIE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:JUNE
Middle Name:MARIE
Last Name:HITE
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 S PARK DR STE F
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76801-5958
Mailing Address - Country:US
Mailing Address - Phone:325-641-1600
Mailing Address - Fax:325-641-1605
Practice Address - Street 1:120 S PARK DR STE F
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-5958
Practice Address - Country:US
Practice Address - Phone:325-641-1600
Practice Address - Fax:325-641-1605
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-12
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX527553363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX159001002Medicaid
TX159001002Medicaid