Provider Demographics
NPI:1285443291
Name:HUNTER, NYA NICOLE
Entity type:Individual
Prefix:
First Name:NYA
Middle Name:NICOLE
Last Name:HUNTER
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 1:2901 UNIVERSITY MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63121-4600
Mailing Address - Country:US
Mailing Address - Phone:217-553-9846
Mailing Address - Fax:217-553-9846
Practice Address - Street 1:12380 DE PAUL DR, BRIDGETON, MO
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63044-2512
Practice Address - Country:US
Practice Address - Phone:314-447-9700
Practice Address - Fax:717-547-8956
Is Sole Proprietor?:No
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider