Healthcare Provider Details

I. General information

NPI: 1033591987
Provider Name (Legal Business Name): DAPHNE ASHLEY HUTCHINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DAPHNE ELIZABETH ASHLEY RPH

II. Dates (important events)

Enumeration Date: 06/26/2015
Last Update Date: 06/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 N MADISON BLVD
ROXBORO NC
27573-4529
US

IV. Provider business mailing address

1005 N MADISON BLVD
ROXBORO NC
27573-4529
US

V. Phone/Fax

Practice location:
  • Phone: 336-599-0851
  • Fax: 336-599-6194
Mailing address:
  • Phone: 336-599-0851
  • Fax: 336-599-6194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13859
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: