Provider Demographics
NPI:1396050944
Name:LUNT, RICHARD SCOTT (FNP-C)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:SCOTT
Last Name:LUNT
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1625
Mailing Address - Street 2:827 VISTA AVE
Mailing Address - City:PAGE
Mailing Address - State:AZ
Mailing Address - Zip Code:86040-1625
Mailing Address - Country:US
Mailing Address - Phone:928-645-9675
Mailing Address - Fax:928-645-2626
Practice Address - Street 1:227 MAIN ST
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:AZ
Practice Address - Zip Code:85534
Practice Address - Country:US
Practice Address - Phone:928-359-1380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-06
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3746363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZRN119324OtherARIZONA RN LICENSE NUMBER
AZAP3746OtherARIZONA AP CERTIFICATION NUMBER