Healthcare Provider Details

I. General information

NPI: 1740211358
Provider Name (Legal Business Name): SCOTT CAMERON HUNTER CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 12/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12305 HARDEE RD
RALEIGH NC
27614-9223
US

IV. Provider business mailing address

12305 HARDEE RD
RALEIGH NC
27614-9223
US

V. Phone/Fax

Practice location:
  • Phone: 919-844-9950
  • Fax:
Mailing address:
  • Phone: 919-844-9950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number155734
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: