Healthcare Provider Details

I. General information

NPI: 1154920346
Provider Name (Legal Business Name): NANCY HUNTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2020
Last Update Date: 10/20/2020
Certification Date: 10/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

638 COMMERCIAL AVE SW
NEW PHILADELPHIA OH
44663-9365
US

IV. Provider business mailing address

9598 BUNKER HILL RD SW
PORT WASHINGTON OH
43837-9114
US

V. Phone/Fax

Practice location:
  • Phone: 330-663-1617
  • Fax:
Mailing address:
  • Phone: 330-340-4129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: