Provider Demographics
NPI:1982275988
Name:HUNTER, RACHELLE (CNIM)
Entity Type:Individual
Prefix:
First Name:RACHELLE
Middle Name:
Last Name:HUNTER
Suffix:
Gender:F
Credentials:CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 YELLOWSTONE AVE # 191
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-4312
Mailing Address - Country:US
Mailing Address - Phone:208-569-8623
Mailing Address - Fax:
Practice Address - Street 1:4205 COCHISE DRIVE
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83406
Practice Address - Country:US
Practice Address - Phone:208-569-8623
Practice Address - Fax:855-463-7123
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic