Healthcare Provider Details

I. General information

NPI: 1548529043
Provider Name (Legal Business Name): LORRAINE STEPHANIE HUTCHINSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2012
Last Update Date: 09/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1443 E 37TH ST
BROOKLYN NY
11234-2801
US

IV. Provider business mailing address

1443 E 37TH ST
BROOKLYN NY
11234-2801
US

V. Phone/Fax

Practice location:
  • Phone: 718-791-4702
  • Fax:
Mailing address:
  • Phone: 718-791-4702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number502911
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF336551
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: