Healthcare Provider Details
I. General information
NPI: 1013976018
Provider Name (Legal Business Name): SYLVIA ALICE HUTCHINGS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/20/2006
Last Update Date: 11/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3921 JOHNS CREEK CT
SUWANEE GA
30024-1265
US
IV. Provider business mailing address
PO BOX 740209 DEPT 1029
ATLANTA GA
30374-0209
US
V. Phone/Fax
- Phone: 678-475-1606
- Fax:
- Phone: 941-360-1566
- Fax: 941-358-9818
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | RN035136 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: