Provider Demographics
NPI:1750621421
Name:HUNNICUTT, RITA (RN)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:HUNNICUTT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE ROCK CREEK DRIVE
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74801
Mailing Address - Country:US
Mailing Address - Phone:405-820-3893
Mailing Address - Fax:
Practice Address - Street 1:1 ROCK CREEK DR
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74801-6668
Practice Address - Country:US
Practice Address - Phone:405-820-3893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-18
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK0060272163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse