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NPI Code Detail

MEDICARE: TRICA GENE DE LA HUNT NP

MEDICARE:   TRICA GENE DE LA HUNT  NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerCNP 3521MN
2363LF0000XFamily Nurse PractitionerR177443-2MN

General Provider Information

NPI Number : 1104224336
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRICA GENE DE LA HUNT NP
Provider Business Mailing Address
First Line : 705 5TH ST NW
Second Line : SUITE D
City : BEMIDJI
State : MN
Zip : 56601-2932
Country : US
Telephone Number : 218-444-7186
Fax Number :
Provider Business Practice Location Address
First Line : 705 5TH ST NW
Second Line : SUITE D
City : BEMIDJI
State : MN
Zip : 56601-2932
Country : US
Telephone Number : 218-444-7186
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2014
Last Update Date : 03/24/2016

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Directions to “ TRICA GENE DE LA HUNT NP” Practice Location

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