Provider Demographics
NPI:1932440278
Name:HUNT, PAMELA FERNE (LPN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:FERNE
Last Name:HUNT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:FERNE
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:712 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DE FOREST
Mailing Address - State:WI
Mailing Address - Zip Code:53532-1451
Mailing Address - Country:US
Mailing Address - Phone:608-333-3979
Mailing Address - Fax:
Practice Address - Street 1:712 S MAIN ST
Practice Address - Street 2:
Practice Address - City:DE FOREST
Practice Address - State:WI
Practice Address - Zip Code:53532-1451
Practice Address - Country:US
Practice Address - Phone:608-333-3979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI000000000309778164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse