Basic Information
Provider Information
NPI: 1699152405
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUNTER
FirstName: JENNIFER
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: DNP
OtherOrganizationName:  
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Mailing Information
Address1: 3030 N CENTRAL AVE STE 1001
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850122716
CountryCode: US
TelephoneNumber: 6024064786
FaxNumber: 9166364358
Practice Location
Address1: 485 S DOBSON RD STE 201
Address2:  
City: CHANDLER
State: AZ
PostalCode: 85224
CountryCode: US
TelephoneNumber: 4807284700
FaxNumber: 4807284747
Other Information
ProviderEnumerationDate: 04/30/2015
LastUpdateDate: 08/10/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/10/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LC0200XAPN.0991678-NPCON Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
363LA2200XAP7747AZY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


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