Individual
MRS. JAN L HUNDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS
Contact information
Practice address
1237 JEFFERSON ST, BOYDTON, VA 23917
(434) 738-0055
(434) 738-0055
Mailing address
PO BOX 66, BOYDTON, VA 23917
(434) 738-0055
(434) 738-0055
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
552
NC
364SP0807X
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
Primary
0015000286
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106480
ANTHEM BCBS
VA
05
—
5510040
—
VA
Enumeration date
07/18/2006
Last updated
11/17/2010
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