Healthcare Provider Details

I. General information

NPI: 1205584166
Provider Name (Legal Business Name): WHITNEY RAE HUTCHISON PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2022
Last Update Date: 03/10/2022
Certification Date: 03/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 COMANCHE RD
FORT MEADE SD
57741-1002
US

IV. Provider business mailing address

1549 OTTER RD
STURGIS SD
57785-3340
US

V. Phone/Fax

Practice location:
  • Phone: 605-347-2511
  • Fax: 612-725-1330
Mailing address:
  • Phone: 605-208-2044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number6864
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: