Provider Demographics
NPI:1730969593
Name:HUNT, KASSIE ANNE (NP)
Entity type:Individual
Prefix:
First Name:KASSIE
Middle Name:ANNE
Last Name:HUNT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:IN
Mailing Address - Zip Code:47960-2211
Mailing Address - Country:US
Mailing Address - Phone:574-240-1111
Mailing Address - Fax:
Practice Address - Street 1:301 W HARRISON ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:IN
Practice Address - Zip Code:47960-2211
Practice Address - Country:US
Practice Address - Phone:574-240-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71014429A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health