Healthcare Provider Details

I. General information

NPI: 1790956522
Provider Name (Legal Business Name): APRIL LYNNE HUTTO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2008
Last Update Date: 10/10/2023
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 BLANDING ST STE 4
COLUMBIA SC
29201-2922
US

IV. Provider business mailing address

1415 BLANDING ST STE 4
COLUMBIA SC
29201-2922
US

V. Phone/Fax

Practice location:
  • Phone: 803-779-7500
  • Fax: 803-779-7522
Mailing address:
  • Phone: 803-605-3368
  • Fax: 803-779-7522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3486
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3486
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: