Provider Demographics
NPI:1720110059
Name:HUNT, DAWN STEPHANIE (DN 112420)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:STEPHANIE
Last Name:HUNT
Suffix:
Gender:F
Credentials:DN 112420
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6513 SHERRY LN
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32095-8222
Mailing Address - Country:US
Mailing Address - Phone:904-217-9518
Mailing Address - Fax:
Practice Address - Street 1:6513 SHERRY LN
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32095-8222
Practice Address - Country:US
Practice Address - Phone:904-217-9518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5199930164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
2702743Medicare UPIN