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General NPI Number Information
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NPI Number | 1285652057
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Entity Type | Individual
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Provider Name | JAN L HUNDLEY CNS
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Gender | Female
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 11/17/2010
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Provider Practice Location Address
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Address Line | 1237 JEFFERSON ST
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City | BOYDTON
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State | VA
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Zip | 23917
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Country | US
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Telephone | 434-738-0055
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Fax | 434-738-0055
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Provider Business Mailing Address
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Address Line | PO BOX 66
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City | BOYDTON
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State | VA
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Zip | 23917
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Country | US
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Telephone | 434-738-0055
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Fax | 434-738-0055
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 0015000286
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 552
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License Number State | NC
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