Healthcare Provider Details

I. General information

NPI: 1376518183
Provider Name (Legal Business Name): DEBORAH JOANN HUNTER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 12/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 SIRINGO RD SUITE # 201
SANTA FE NM
87505-5863
US

IV. Provider business mailing address

130 SIRINGO RD SUITE # 201
SANTA FE NM
87505-5863
US

V. Phone/Fax

Practice location:
  • Phone: 505-989-3236
  • Fax: 505-989-5079
Mailing address:
  • Phone: 505-989-3236
  • Fax: 505-989-5079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR41565
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: