Provider Demographics
NPI:1841546165
Name:HANTER, HERBERT HAYDEN (NP)
Entity type:Individual
Prefix:
First Name:HERBERT
Middle Name:HAYDEN
Last Name:HANTER
Suffix:
Gender:M
Credentials:NP
Other - Prefix:MR
Other - First Name:HERBERT
Other - Middle Name:TORINO
Other - Last Name:CAGAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:2625 E DIVISADERO ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1431
Mailing Address - Country:US
Mailing Address - Phone:559-443-2682
Mailing Address - Fax:559-443-2681
Practice Address - Street 1:290 N WAYTE LN
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-2124
Practice Address - Country:US
Practice Address - Phone:559-459-5721
Practice Address - Fax:559-459-4922
Is Sole Proprietor?:No
Enumeration Date:2012-07-25
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20813363LF0000X
CANP20813363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily