Healthcare Provider Details

I. General information

NPI: 1871460287
Provider Name (Legal Business Name): MRS. KATRINA HUTCHINSON-PROVINCE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2025
Last Update Date: 10/24/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1447 E 84TH ST
BROOKLYN NY
11236-5127
US

IV. Provider business mailing address

1447 E 84TH ST
BROOKLYN NY
11236-5127
US

V. Phone/Fax

Practice location:
  • Phone: 347-760-2242
  • Fax:
Mailing address:
  • Phone: 347-760-2242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number780087
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number780087
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number780087
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number780087
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number780087
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: