Healthcare Provider Details

I. General information

NPI: 1205332368
Provider Name (Legal Business Name): JOANNA MAE HUNT CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2018
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 TWINING ST BLDG 760
MAXWELL AFB AL
36112-6027
US

IV. Provider business mailing address

300 TWINING ST BLDG 760
MAXWELL AFB AL
36112-6027
US

V. Phone/Fax

Practice location:
  • Phone: 334-953-5200
  • Fax: 334-953-8607
Mailing address:
  • Phone: 334-953-5200
  • Fax: 334-953-8607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-113269
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: