Healthcare Provider Details

I. General information

NPI: 1346754207
Provider Name (Legal Business Name): CAROLINE TAUTZ HUTTO CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROLINE LUISE TAUTZ RN

II. Dates (important events)

Enumeration Date: 11/29/2017
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 AIRPORT WAY STE 5
FAIRBANKS AK
99709-4772
US

IV. Provider business mailing address

3550 AIRPORT WAY STE 4
FAIRBANKS AK
99709-4772
US

V. Phone/Fax

Practice location:
  • Phone: 907-290-8430
  • Fax: 907-290-4337
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number128999
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: