Provider Demographics
NPI:1316052244
Name:LUNT, CAROL ANNE (NP)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:ANNE
Last Name:LUNT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 NEWPOINT LANE
Mailing Address - Street 2:
Mailing Address - City:E MORICHES
Mailing Address - State:NY
Mailing Address - Zip Code:11940
Mailing Address - Country:US
Mailing Address - Phone:631-878-8309
Mailing Address - Fax:
Practice Address - Street 1:240 MEETING HOUSE LANE
Practice Address - Street 2:
Practice Address - City:SOUTHHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11968
Practice Address - Country:US
Practice Address - Phone:631-852-8853
Practice Address - Fax:631-852-8857
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF360327363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
S85736Medicare UPIN
94V312Medicare ID - Type Unspecified