Healthcare Provider Details

I. General information

NPI: 1124720867
Provider Name (Legal Business Name): LUCY HUTCHINGS RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 03/20/2023
Certification Date: 03/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

571 TURNPIKE RD
NEW IPSWICH NH
03071-3644
US

IV. Provider business mailing address

PO BOX 131
NEW IPSWICH NH
03071-0131
US

V. Phone/Fax

Practice location:
  • Phone: 978-226-8164
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number994303
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: