Healthcare Provider Details

I. General information

NPI: 1871306514
Provider Name (Legal Business Name): NUTRINEE KULVISATE HUTCHISON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2025
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6312 GARWOOD AVE
LAS VEGAS NV
89107-2560
US

IV. Provider business mailing address

6312 GARWOOD AVE
LAS VEGAS NV
89107-2560
US

V. Phone/Fax

Practice location:
  • Phone: 725-666-3799
  • Fax:
Mailing address:
  • Phone: 725-666-3799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number885788
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: