Healthcare Provider Details

I. General information

NPI: 1417138405
Provider Name (Legal Business Name): CAROL ANN HUTCHENS ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2007
Last Update Date: 11/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 FRANKLIN ST
ENGLEWOOD NJ
07631-3616
US

IV. Provider business mailing address

174 GRAND AVE
ENGLEWOOD NJ
07631-3585
US

V. Phone/Fax

Practice location:
  • Phone: 201-894-1516
  • Fax:
Mailing address:
  • Phone: 201-894-1516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number26NR05502500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: