Provider Demographics
NPI:1356574917
Name:HUNT, AUDREY ROSE (ARNP)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:ROSE
Last Name:HUNT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:AUDREY
Other - Middle Name:ROSE
Other - Last Name:MATTINGLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:79 BOBOLINK DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:40069-1516
Mailing Address - Country:US
Mailing Address - Phone:859-336-0771
Mailing Address - Fax:859-336-0772
Practice Address - Street 1:137 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:KY
Practice Address - Zip Code:40069-2200
Practice Address - Country:US
Practice Address - Phone:859-336-0771
Practice Address - Fax:859-336-0772
Is Sole Proprietor?:No
Enumeration Date:2009-08-31
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1100216363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily