Individual provider Active NPI

Trica Gene De la Hunt, NP

  • Family Nurse Practitioner
  • Bemidji, MN
National Provider Identifier
1104224336
Registry record updated Mar 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP 3521 Issued in MN
Practice address
705 5TH St NW
Suite D
Bemidji, MN 56601-2932
Phone
(218) 444-7186
NPI assigned
Dec 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP 3521 MN Primary
Family Nurse Practitioner 363LF0000X R177443-2 MN

Addresses

Primary practice location

705 5TH St NW
Suite D
Bemidji, MN 56601-2932

Mailing address

705 5TH St NW
Suite D
Bemidji, MN 56601-2932
Phone (218) 444-7186

Other names 1

  • Tricia Gene Henderson Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R177443-2MNMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1419206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458777600000",
    "number": "1104224336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 5TH ST NW",
            "address_2": "SUITE D",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566012932",
            "telephone_number": "218-444-7186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 5TH ST NW",
            "address_2": "SUITE D",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566012932",
            "telephone_number": "218-444-7186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA HUNT",
        "first_name": "TRICA",
        "middle_name": "GENE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-22",
        "last_updated": "2016-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP 3521",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R177443-2",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRICIA",
            "last_name": "HENDERSON",
            "middle_name": "GENE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bemidji, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.