Provider Demographics
NPI:1992980742
Name:HUNTER, MERCY G (NP-C)
Entity type:Individual
Prefix:
First Name:MERCY
Middle Name:G
Last Name:HUNTER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MRS
Other - First Name:MERCY
Other - Middle Name:G
Other - Last Name:HUNTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP-C
Mailing Address - Street 1:1505 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-3761
Mailing Address - Country:US
Mailing Address - Phone:831-722-1444
Mailing Address - Fax:831-722-4414
Practice Address - Street 1:1505 MAIN ST
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-3761
Practice Address - Country:US
Practice Address - Phone:831-722-1444
Practice Address - Fax:831-722-4414
Is Sole Proprietor?:No
Enumeration Date:2007-12-28
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX775099363LA2200X
MSR866418363LA2200X
CA95003641363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM62-1766956OtherTIN