Healthcare Provider Details

I. General information

NPI: 1447029046
Provider Name (Legal Business Name): PUTSANEE HUTCHINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2023
Last Update Date: 12/22/2023
Certification Date: 12/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 PALMER ST
NORTH LAS VEGAS NV
89030-7437
US

IV. Provider business mailing address

1900 PALMER ST
NORTH LAS VEGAS NV
89030-7437
US

V. Phone/Fax

Practice location:
  • Phone: 702-610-1179
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: