Healthcare Provider Details

I. General information

NPI: 1760936355
Provider Name (Legal Business Name): FERNITRICE DHANA HUNTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2016
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17732 N KARI LN
MARICOPA AZ
85139-6787
US

IV. Provider business mailing address

PO BOX 86537
TUCSON AZ
85754-6537
US

V. Phone/Fax

Practice location:
  • Phone: 520-721-1887
  • Fax: 520-372-7126
Mailing address:
  • Phone: 520-232-2863
  • Fax: 520-372-7126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number1875709
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: