Healthcare Provider Details

I. General information

NPI: 1235587148
Provider Name (Legal Business Name): STEPHANIE HUTCHISON CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2016
Last Update Date: 11/03/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2109 HUGHES DR #220
TOLEDO OH
43606-3856
US

IV. Provider business mailing address

2109 HUGHES DR #220
TOLEDO OH
43606-3856
US

V. Phone/Fax

Practice location:
  • Phone: 419-291-5150
  • Fax: 419-479-6173
Mailing address:
  • Phone: 419-291-5150
  • Fax: 419-479-6173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number337116
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: