Basic Information
Provider Information | |||||||||
NPI: | 1992296891 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | HUNTER | ||||||||
FirstName: | KRISTINA | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | MERCYONE WATERLOO OB/GYN | ||||||||
Address2: | 3421 W 9TH ST STE G4500 | ||||||||
City: | WATERLOO | ||||||||
State: | IA | ||||||||
PostalCode: | 507025401 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3192728200 | ||||||||
FaxNumber: | 3192720400 | ||||||||
Practice Location | |||||||||
Address1: | MERCYONE WATERLOO OB/GYN | ||||||||
Address2: | 3421 W 9TH ST STE G4500 | ||||||||
City: | WATERLOO | ||||||||
State: | IA | ||||||||
PostalCode: | 507025401 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3192728200 | ||||||||
FaxNumber: | 3192720400 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/25/2018 | ||||||||
LastUpdateDate: | 07/01/2022 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 06/23/2022 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | MD49399 | IA | Y |   | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |   | 390200000X |   | CT | N |   | Student, Health Care | Student in an Organized Health Care Education/Training Program |   |
No ID Information.