Healthcare Provider Details

I. General information

NPI: 1336531300
Provider Name (Legal Business Name): MARY BENSON HUNTER NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2015
Last Update Date: 02/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451 FILLINGIM ST
MOBILE AL
36617-2238
US

IV. Provider business mailing address

6945 CARSON LN
SPANISH FORT AL
36527-7014
US

V. Phone/Fax

Practice location:
  • Phone: 251-471-7000
  • Fax:
Mailing address:
  • Phone: 251-599-0232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-127454
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: