Healthcare Provider Details

I. General information

NPI: 1538894035
Provider Name (Legal Business Name): ERICKA HUTCHINS BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2022
Last Update Date: 07/19/2022
Certification Date: 07/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1517 BIRCH RIDGE CT
STONE MOUNTAIN GA
30083-5601
US

IV. Provider business mailing address

1517 BIRCH RIDGE CT
STONE MOUNTAIN GA
30083-5601
US

V. Phone/Fax

Practice location:
  • Phone: 470-609-0193
  • Fax:
Mailing address:
  • Phone: 470-609-0193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2976948
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number2976948
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number2976948
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code374700000X
TaxonomyTechnician
License Number0030032480
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number0030032480
License Number StateGA
# 6
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number0030032480
License Number StateGA
# 7
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number0030032480
License Number StateGA
# 8
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number0030032480
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: