Provider Demographics
NPI:1154870087
Name:HUNTER, BRYAN COLE (NP)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:COLE
Last Name:HUNTER
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1848
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49443-1848
Mailing Address - Country:US
Mailing Address - Phone:231-672-2120
Mailing Address - Fax:313-432-7758
Practice Address - Street 1:601 W SAVIDGE ST
Practice Address - Street 2:
Practice Address - City:SPRING LAKE
Practice Address - State:MI
Practice Address - Zip Code:49456-1620
Practice Address - Country:US
Practice Address - Phone:231-672-3100
Practice Address - Fax:231-672-3102
Is Sole Proprietor?:No
Enumeration Date:2016-10-04
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704302038363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily