Healthcare Provider Details

I. General information

NPI: 1902681000
Provider Name (Legal Business Name): AMANDA HUTCHERSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2023
Last Update Date: 08/28/2023
Certification Date: 08/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2505 S MEBANE ST
BURLINGTON NC
27215-6385
US

IV. Provider business mailing address

1968 MCCRAY RD
BURLINGTON NC
27217-8535
US

V. Phone/Fax

Practice location:
  • Phone: 336-223-0444
  • Fax:
Mailing address:
  • Phone: 336-269-2118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number202474
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: