Healthcare Provider Details

I. General information

NPI: 1083431027
Provider Name (Legal Business Name): TRAVONNA M HUNTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2024
Last Update Date: 08/17/2025
Certification Date: 08/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

413 E HOME RD
SPRINGFIELD OH
45503-2708
US

IV. Provider business mailing address

2155 OLYMPIC ST
SPRINGFIELD OH
45503-2766
US

V. Phone/Fax

Practice location:
  • Phone: 904-803-3805
  • Fax:
Mailing address:
  • Phone: 904-803-3805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1744R1103X
TaxonomyResearch Study Abstracter/Coder
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: