Healthcare Provider Details

I. General information

NPI: 1720066681
Provider Name (Legal Business Name): ADELA HUNT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2006
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2066 STATE ROAD 16 W
GREEN COVE SPRINGS FL
32043-8526
US

IV. Provider business mailing address

2066 STATE ROAD 16 W
GREEN COVE SPRINGS FL
32043-8526
US

V. Phone/Fax

Practice location:
  • Phone: 313-485-1390
  • Fax:
Mailing address:
  • Phone: 313-485-1390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9222088
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number9222088
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: