Provider Demographics
NPI:1366077737
Name:HUNTER, ABBY WELLS
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:WELLS
Last Name:HUNTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1621 E BROOMFIELD ST STE C
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-5427
Mailing Address - Country:US
Mailing Address - Phone:989-817-4600
Mailing Address - Fax:
Practice Address - Street 1:1621 E BROOMFIELD ST STE C
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-5427
Practice Address - Country:US
Practice Address - Phone:989-817-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-06
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704292296NSA2005E363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily