Provider Demographics
NPI:1588075709
Name:HUNTER, TERESA (CRNP)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:HUNTER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:
Other - Last Name:WILDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:2001 GUNTER AVE
Mailing Address - Street 2:
Mailing Address - City:GUNTERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35976-2126
Mailing Address - Country:US
Mailing Address - Phone:256-264-0818
Mailing Address - Fax:256-264-0820
Practice Address - Street 1:2001 GUNTER AVE
Practice Address - Street 2:
Practice Address - City:GUNTERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35976-2126
Practice Address - Country:US
Practice Address - Phone:256-264-0818
Practice Address - Fax:256-264-0820
Is Sole Proprietor?:No
Enumeration Date:2014-05-09
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-050446363L00000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL231700Medicaid