MEDICARE: LAURIE HUTCHINS APRN

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	363LF0000X	Family Nurse Practitioner	RN211666	GA

General Provider Information

NPI Number	:	1780179390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURIE HUTCHINS APRN

Provider Business Mailing Address
First Line	:	215 N COLEMAN ST
Second Line	:
City	:	SWAINSBORO
State	:	GA
Zip	:	30401-3530
Country	:	US
Telephone Number	:	478-237-2638
Fax Number	:	478-237-9138

Provider Business Practice Location Address
First Line	:	118 E BROAD ST
Second Line	:
City	:	MOUNT VERNON
State	:	GA
Zip	:	30445-3018
Country	:	US
Telephone Number	:	912-583-2277
Fax Number	:	912-583-2286

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

Provider Enumeration Date	:	06/26/2018
Last Update Date	:	06/26/2018

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