Healthcare Provider Details

I. General information

NPI: 1003033481
Provider Name (Legal Business Name): NAN L HUNT MSW LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3949 SPARKS DR SE SUITE 103
GRAND RAPIDS MI
49546
US

IV. Provider business mailing address

11757 FORESTWOOD DRIVE
CEDAR SPRINGS MI
49319
US

V. Phone/Fax

Practice location:
  • Phone: 616-957-5850
  • Fax:
Mailing address:
  • Phone: 616-437-2425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: