Basic Information
Provider Information
NPI: 1487168662
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUNT
FirstName: KATLIN
MiddleName: ELIZABETH
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 500 ACADEMY ST S
Address2:  
City: AHOSKIE
State: NC
PostalCode: 279103248
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 500 ACADEMY ST S
Address2:  
City: AHOSKIE
State: NC
PostalCode: 279103248
CountryCode: US
TelephoneNumber: 2522093000
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/26/2017
LastUpdateDate: 03/07/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0808X5010334NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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