Provider Demographics
NPI:1144465600
Name:HUNT, JEREMY R (CRNP)
Entity type:Individual
Prefix:
First Name:JEREMY
Middle Name:R
Last Name:HUNT
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 S CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:PA
Mailing Address - Zip Code:15501-2033
Mailing Address - Country:US
Mailing Address - Phone:814-443-5183
Mailing Address - Fax:
Practice Address - Street 1:1050 W INDUSTRIAL BLVD STE 17
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-4331
Practice Address - Country:US
Practice Address - Phone:240-964-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-11
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV92785363L00000X
PARN535363363LF0000X
PASP010011363LF0000X
MDR195446363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASP010011OtherNURSE PRACTIONER ID#
PARN535363OtherCRNP LICENSE NUMBER
MDR195446OtherCRNP-NURSE PRACTITIONER
WV92785OtherCRNP-NURSE PRACTITIONER