Healthcare Provider Details

I. General information

NPI: 1760448807
Provider Name (Legal Business Name): SHILO LEE HUTCHINS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 01/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 NEWMARKET ST VA PRIMARY CARE CLINIC PORTSMOUTH CBOC
NEWINGTON NH
03803
US

IV. Provider business mailing address

302 NEWMARKET ST VA PRIMARY CARE CLINIC PORTSMOUTH CBOC
NEWINGTON NH
03803
US

V. Phone/Fax

Practice location:
  • Phone: 800-892-8384
  • Fax: 603-314-1679
Mailing address:
  • Phone: 800-892-8384
  • Fax: 603-314-1679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number048272-23-05
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: