Healthcare Provider Details

I. General information

NPI: 1639583834
Provider Name (Legal Business Name): JULIE KAYLAN HUTCHENS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2014
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 HIGHWAY 201 N
MOUNTAIN HOME AR
72653-3158
US

IV. Provider business mailing address

PO BOX 2443
MOUNTAIN HOME AR
72654-2443
US

V. Phone/Fax

Practice location:
  • Phone: 870-232-5215
  • Fax: 870-232-5240
Mailing address:
  • Phone: 870-232-5215
  • Fax: 870-232-5240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA004102
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: