Provider Demographics
NPI:1043924202
Name:HUNTER, JAMIE NICOLE (PTA)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:NICOLE
Last Name:HUNTER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 NAMBE ST
Mailing Address - Street 2:
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240-0974
Mailing Address - Country:US
Mailing Address - Phone:575-441-2583
Mailing Address - Fax:
Practice Address - Street 1:1515 E SANGER ST
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-4713
Practice Address - Country:US
Practice Address - Phone:575-433-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPTA0826225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant