Healthcare Provider Details

I. General information

NPI: 1225068778
Provider Name (Legal Business Name): PATRICIA JO HUNTER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 02/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 EDWARDS ST
WESTCLIFFE CO
81252-8588
US

IV. Provider business mailing address

704 EDWARDS ST
WESTCLIFFE CO
81252-8588
US

V. Phone/Fax

Practice location:
  • Phone: 719-783-2380
  • Fax: 719-783-2377
Mailing address:
  • Phone: 719-783-2380
  • Fax: 719-783-2377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN124877
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0002684-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: