MEDICARE: STEFANIE MARIE HUTCHENS FNP-C, RNFA, CNOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	725582	TX
2	163WR0006X	Registered Nurse First Assistant	725582	TX
3	363LF0000X	Family Nurse Practitioner	AP141280	TX

General Provider Information

NPI Number	:	1770729493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEFANIE MARIE HUTCHENS FNP-C, RNFA, CNOR

Provider Business Mailing Address
First Line	:	4925 GREENVILLE AVE STE 1307
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-4026
Country	:	US
Telephone Number	:	214-242-1389
Fax Number	:	214-366-3713

Provider Business Practice Location Address
First Line	:	4925 GREENVILLE AVE STE 1307
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-4026
Country	:	US
Telephone Number	:	214-242-1389
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2008
Last Update Date	:	05/05/2022

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