Healthcare Provider Details

I. General information

NPI: 1174459788
Provider Name (Legal Business Name): ERIN M HUNT GIST
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 W 5TH AVE
RAEFORD NC
28376-2108
US

IV. Provider business mailing address

2848 HILLY BRANCH RD
LUMBERTON NC
28360-0323
US

V. Phone/Fax

Practice location:
  • Phone: 910-875-8009
  • Fax:
Mailing address:
  • Phone: 910-827-0468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5368
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: