Healthcare Provider Details

I. General information

NPI: 1679083281
Provider Name (Legal Business Name): RACHEL HUTCHISON PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2017
Last Update Date: 06/19/2020
Certification Date: 06/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

856 TEXAS AVE
SHREVEPORT LA
71101-3400
US

IV. Provider business mailing address

856 TEXAS AVE
SHREVEPORT LA
71101-3400
US

V. Phone/Fax

Practice location:
  • Phone: 919-371-2848
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberPLC8207
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: