Healthcare Provider Details

I. General information

NPI: 1093828626
Provider Name (Legal Business Name): DONNA HUNT RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 02/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 ALBERT CREE DR
RUTLAND VT
05701-4601
US

IV. Provider business mailing address

8 ALBERT CREE DR
RUTLAND VT
05701-4601
US

V. Phone/Fax

Practice location:
  • Phone: 802-775-2703
  • Fax: 802-775-9017
Mailing address:
  • Phone: 802-775-2703
  • Fax: 802-775-9017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number0740000117
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: