Provider Demographics
NPI:1093537862
Name:HUNT, JACLYN
Entity type:Individual
Prefix:
First Name:JACLYN
Middle Name:
Last Name:HUNT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 NORTON GLEN RD APT 86
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:MA
Mailing Address - Zip Code:02766-2548
Mailing Address - Country:US
Mailing Address - Phone:508-878-8083
Mailing Address - Fax:
Practice Address - Street 1:19 NORTON GLEN RD APT 86
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:MA
Practice Address - Zip Code:02766-2548
Practice Address - Country:US
Practice Address - Phone:508-878-8083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA93236164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MALPN93236OtherMA BOARD OF NURSING