Basic Information
Provider Information
NPI: 1306929419
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUNT
FirstName: KATHRYN
MiddleName: F
NamePrefix:  
NameSuffix:  
Credential: PNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3200 N CENTRAL AVE
Address2: SUITE 900
City: PHOENIX
State: AZ
PostalCode: 850122425
CountryCode: US
TelephoneNumber: 6024063729
FaxNumber: 6027989412
Practice Location
Address1: 124 W THOMAS RD
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850134405
CountryCode: US
TelephoneNumber: 6024066429
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/23/2006
LastUpdateDate: 08/14/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0200XRN039690AZY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics

No ID Information.


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