Healthcare Provider Details

I. General information

NPI: 1457180150
Provider Name (Legal Business Name): MARY ERIN HUTCHESON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2024
Last Update Date: 07/31/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 TIBET AVE APT 105
SAVANNAH GA
31406-9029
US

IV. Provider business mailing address

PO BOX 822
EDEN GA
31307-0822
US

V. Phone/Fax

Practice location:
  • Phone: 912-376-0761
  • Fax:
Mailing address:
  • Phone: 912-655-8103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11011334
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number23594
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number230168
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: