Provider Demographics
NPI:1952142093
Name:HUNERKOCH, PATRICIA LAVERNE
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:LAVERNE
Last Name:HUNERKOCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6278 NEW COLUMBIA RD
Mailing Address - Street 2:
Mailing Address - City:BELKNAP
Mailing Address - State:IL
Mailing Address - Zip Code:62908-2308
Mailing Address - Country:US
Mailing Address - Phone:270-619-5100
Mailing Address - Fax:618-454-4044
Practice Address - Street 1:6278 NEW COLUMBIA RD
Practice Address - Street 2:
Practice Address - City:BELKNAP
Practice Address - State:IL
Practice Address - Zip Code:62908-2308
Practice Address - Country:US
Practice Address - Phone:270-619-5100
Practice Address - Fax:618-454-4044
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL08266565OtherLLC FILE NUMBER