Healthcare Provider Details

I. General information

NPI: 1144665209
Provider Name (Legal Business Name): FLOYD W HUTCHISON PMH-NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2013
Last Update Date: 09/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 ALLENS CREEK RD
ROCHESTER NY
14618-3310
US

IV. Provider business mailing address

132 ALLENS CREEK RD
ROCHESTER NY
14618-3310
US

V. Phone/Fax

Practice location:
  • Phone: 585-241-9330
  • Fax:
Mailing address:
  • Phone: 585-241-9330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF401593-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: