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NPI Code Detail

MEDICARE: LAURA R HUNGERFORD PAC

MEDICARE: LAURA R HUNGERFORD PAC
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
1363A00000XPhysician Assistant14215091-1206UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699720078
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA R HUNGERFORD PAC
Provider Business Mailing Address
First Line : 975 KIRMAN AVE
Second Line :
City : RENO
State : NV
Zip : 89502-0993
Country : US
Telephone Number : 775-219-7228
Fax Number :
Provider Business Practice Location Address
First Line : 975 KIRMAN AVE
Second Line :
City : RENO
State : NV
Zip : 89502-0993
Country : US
Telephone Number : 775-219-7228
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2006
Last Update Date : 12/03/2025

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Directions to “ LAURA R HUNGERFORD PAC” Practice Location

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