Healthcare Provider Details

I. General information

NPI: 1194854752
Provider Name (Legal Business Name): NANCY J HUTCHINSON ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2815 CATES AVE
RALEIGH NC
27695-7304
US

IV. Provider business mailing address

2815 CATES AVE
RALEIGH NC
27695-7304
US

V. Phone/Fax

Practice location:
  • Phone: 919-515-2563
  • Fax: 919-513-1994
Mailing address:
  • Phone: 919-515-2563
  • Fax: 919-513-1994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number00019
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: