Healthcare Provider Details

I. General information

NPI: 1568184349
Provider Name (Legal Business Name): BRETT WILLIAM HUTTON ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 08/10/2023
Certification Date: 08/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 9TH ST SE
SIOUX CENTER IA
51250-2501
US

IV. Provider business mailing address

1101 9TH ST SE
SIOUX CENTER IA
51250-2501
US

V. Phone/Fax

Practice location:
  • Phone: 712-722-1271
  • Fax:
Mailing address:
  • Phone: 712-722-1271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA171141
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: