Healthcare Provider Details

I. General information

NPI: 1346062866
Provider Name (Legal Business Name): HARRIET E CUTTLER AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 CAPP ST
SAN FRANCISCO CA
94110-1209
US

IV. Provider business mailing address

165 CAPP ST
SAN FRANCISCO CA
94110-1209
US

V. Phone/Fax

Practice location:
  • Phone: 415-676-1113
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95032088
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: