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General NPI Number Information
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NPI Number | 1922582709
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Entity Type | Individual
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Provider Name | BRYAN HUNTER LPN
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Gender | Male
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Dates
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Enumeration Date | 09/18/2018
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Last Update Date | 09/18/2018
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Provider Practice Location Address
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Address Line | 180 MAIN RD # ME04414
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City | BROWNVILLE
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State | ME
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Zip | 04414-3107
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Country | US
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Telephone | 866-366-5842
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Fax |
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Provider Business Mailing Address
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Address Line | 529 S PATTEN RD
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City | PATTEN
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State | ME
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Zip | 04765-3007
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Country | US
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Telephone | 866-366-5842
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Fax |
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | LPN13078
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License Number State | ME
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