Healthcare Provider Details

I. General information

NPI: 1710067830
Provider Name (Legal Business Name): THERESA A HUTCHISON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1813 WILLOW ST STE 3
VINCENNES IN
47591-4279
US

IV. Provider business mailing address

1160 E SAINT CLAIR ST
VINCENNES IN
47591-4853
US

V. Phone/Fax

Practice location:
  • Phone: 812-885-8941
  • Fax: 812-885-8940
Mailing address:
  • Phone: 812-885-3325
  • Fax: 812-885-8987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71005025A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number28113526A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71005025B
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: