Provider Demographics
NPI:1992552236
Name:HUNT, NICOLE E
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:E
Last Name:HUNT
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 1:65 NORTH ST APT 89
Mailing Address - Street 2:
Mailing Address - City:MCSHERRYSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17344-1321
Mailing Address - Country:US
Mailing Address - Phone:225-508-0523
Mailing Address - Fax:
Practice Address - Street 1:860 CARLISLE ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1703
Practice Address - Country:US
Practice Address - Phone:225-508-0523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-03
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA30269021183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist