Provider Demographics
NPI:1518389857
Name:HUNT, TERESA D (PA-C)
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:D
Last Name:HUNT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:TERESA
Other - Middle Name:D
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5056 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-1521
Mailing Address - Country:US
Mailing Address - Phone:602-222-9111
Mailing Address - Fax:602-222-9333
Practice Address - Street 1:5056 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-1521
Practice Address - Country:US
Practice Address - Phone:602-222-9111
Practice Address - Fax:602-222-9333
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-06
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
AZ7521363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant