Healthcare Provider Details

I. General information

NPI: 1386614261
Provider Name (Legal Business Name): VALERIA F. HUTCHINSON CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 01/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10628 PARK RD
CHARLOTTE NC
28210-8407
US

IV. Provider business mailing address

10628 PARK RD
CHARLOTTE NC
28210-8407
US

V. Phone/Fax

Practice location:
  • Phone: 704-667-1900
  • Fax: 704-667-1990
Mailing address:
  • Phone: 704-667-1000
  • Fax: 704-667-1990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number077235
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: