Provider Demographics
NPI:1063144343
Name:HUNT, DAUREEN CORANNA (LPN)
Entity type:Individual
Prefix:
First Name:DAUREEN
Middle Name:CORANNA
Last Name:HUNT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 MAPLE PL
Mailing Address - Street 2:
Mailing Address - City:ILION
Mailing Address - State:NY
Mailing Address - Zip Code:13357-2258
Mailing Address - Country:US
Mailing Address - Phone:315-219-7754
Mailing Address - Fax:
Practice Address - Street 1:54 MAPLE PL
Practice Address - Street 2:
Practice Address - City:ILION
Practice Address - State:NY
Practice Address - Zip Code:13357-2258
Practice Address - Country:US
Practice Address - Phone:315-219-7754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY273346-01164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse