Provider Demographics
NPI:1649445800
Name:HUNT, RASELETTE AGATHA
Entity type:Individual
Prefix:DR
First Name:RASELETTE
Middle Name:AGATHA
Last Name:HUNT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RASELETTE
Other - Middle Name:AGATHA
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2292 FOREST LN
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-6004
Mailing Address - Country:US
Mailing Address - Phone:717-513-1499
Mailing Address - Fax:
Practice Address - Street 1:2292 FOREST LN
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-6004
Practice Address - Country:US
Practice Address - Phone:717-513-1499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD444348207Q00000X
FLME111370207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine