Basic Information
Provider Information
NPI: 1528361581
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUNTER
FirstName: CHERISE
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: CNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: THOMPSON
OtherFirstName: CHERISE
OtherMiddleName: A
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: CRNP
OtherLastNameType: 1
Mailing Information
Address1: 353 FAIRMONT BLVD
Address2: ATTEN CHRISTIE MSS
City: RAPID CITY
State: SD
PostalCode: 577017350
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 353 FAIRMONT BLVD.
Address2:  
City: RAPID CITY
State: SD
PostalCode: 57701
CountryCode: US
TelephoneNumber: 6057191000
FaxNumber: 6057198826
Other Information
ProviderEnumerationDate: 12/14/2010
LastUpdateDate: 06/24/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XCP000783SDY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363LA2100XR042481SDN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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