Healthcare Provider Details

I. General information

NPI: 1023871829
Provider Name (Legal Business Name): KRISTIN HUNKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 OLD NC 86 STE 105
HILLSBOROUGH NC
27278-8788
US

IV. Provider business mailing address

301 LITTLE LAWSON LN APT 201
CARY NC
27519-7274
US

V. Phone/Fax

Practice location:
  • Phone: 919-732-2909
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberL007683
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: