1396050944 NPI number — RICHARD SCOTT LUNT FNP-C

Table of content: RICHARD SCOTT LUNT FNP-C (NPI 1396050944)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396050944 NPI number — RICHARD SCOTT LUNT FNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LUNT
Provider First Name:
RICHARD
Provider Middle Name:
SCOTT
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP-C
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396050944
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/06/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1625
Provider Second Line Business Mailing Address:
827 VISTA AVE
Provider Business Mailing Address City Name:
PAGE
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
86040-1625
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
928-645-9675
Provider Business Mailing Address Fax Number:
928-645-2626

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
227 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUNCAN
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85534
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-359-1380
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/06/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  AP3746 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: RN119324 . This is a "ARIZONA RN LICENSE NUMBER" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: AP3746 . This is a "ARIZONA AP CERTIFICATION NUMBER" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".




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