=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801169404
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LINDSEY MARIE HUNTER PA-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/14/2012
-----------------------------------------------------
Last Update Date | 09/02/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11 N MAPLE ST
-----------------------------------------------------
City | GRANT
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49327-7900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 231-834-0444
-----------------------------------------------------
Fax | 231-834-0200
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 261 N MAIN
-----------------------------------------------------
City | CEDAR SPRINGS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49319-8041
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 166-696-2020
-----------------------------------------------------
Fax | 877-779-0621
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | 5601006300
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------