Healthcare Provider Details

I. General information

NPI: 1841348950
Provider Name (Legal Business Name): RHONDA CARTER HUTTO NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 01/12/2023
Certification Date: 01/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 PRUDENTIAL DR UFJAX - DEPT. OF PEDIATRICS/NEONATOLOGY
JACKSONVILLE FL
32207-8210
US

IV. Provider business mailing address

50 S SUNSET RIDGE DR
WILLOW SPRING NC
27592-8432
US

V. Phone/Fax

Practice location:
  • Phone: 904-202-2330
  • Fax: 904-244-3401
Mailing address:
  • Phone: 252-414-4481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number082772
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: