Healthcare Provider Details

I. General information

NPI: 1124732417
Provider Name (Legal Business Name): SCOTT RYAN HUTCHISON DNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2023
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10211 ALM ST STE 1200
RALEIGH NC
27617-8221
US

IV. Provider business mailing address

3000 ROGERS RD STE 100
WAKE FOREST NC
27587-5745
US

V. Phone/Fax

Practice location:
  • Phone: 919-206-4889
  • Fax:
Mailing address:
  • Phone: 919-385-1601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number308500
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5022440
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: