Provider Demographics
NPI:1386988277
Name:HUNTER, ELIZABETH A (RN)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:HUNTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MEDICAL PLZ
Mailing Address - Street 2:530
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-0001
Mailing Address - Country:US
Mailing Address - Phone:310-825-7922
Mailing Address - Fax:310-267-1899
Practice Address - Street 1:200 MEDICAL PLZ
Practice Address - Street 2:530
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-0001
Practice Address - Country:US
Practice Address - Phone:310-825-7922
Practice Address - Fax:310-267-1899
Is Sole Proprietor?:No
Enumeration Date:2012-11-16
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN 682268163W00000X, 163WD0400X, 163WN1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN1003XNursing Service ProvidersRegistered NurseNutrition Support
No163W00000XNursing Service ProvidersRegistered Nurse
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator