Healthcare Provider Details

I. General information

NPI: 1235561622
Provider Name (Legal Business Name): PHOEBE ANTOINETTE HUTCHINSON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2013
Last Update Date: 10/08/2020
Certification Date: 10/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2626 CAPITAL MEDICAL BLVD
TALLAHASSEE FL
32308-4402
US

IV. Provider business mailing address

2626 CAPITAL MEDICAL BLVD
TALLAHASSEE FL
32308-4402
US

V. Phone/Fax

Practice location:
  • Phone: 850-325-5257
  • Fax:
Mailing address:
  • Phone: 850-325-5257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number2896572
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number2896572
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: