Healthcare Provider Details

I. General information

NPI: 1750884581
Provider Name (Legal Business Name): LAUREN ELISABETH HUTCHESON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2018
Last Update Date: 10/06/2021
Certification Date: 10/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925B PEACHTREE ST NE STE 710
ATLANTA GA
30309-3918
US

IV. Provider business mailing address

328 CRONAN DR
MCDONOUGH GA
30252-2637
US

V. Phone/Fax

Practice location:
  • Phone: 303-704-4621
  • Fax:
Mailing address:
  • Phone: 720-810-9487
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: