Healthcare Provider Details

I. General information

NPI: 1801924592
Provider Name (Legal Business Name): LIZA HUNTER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 ALBANY ST
BOSTON MA
02118
US

IV. Provider business mailing address

51 HYDE STREET
NEWTON MA
02461
US

V. Phone/Fax

Practice location:
  • Phone: 857-654-1000
  • Fax: 857-654-1100
Mailing address:
  • Phone: 857-891-8755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number236161
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN236161
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: