Healthcare Provider Details

I. General information

NPI: 1326479825
Provider Name (Legal Business Name): SARAH ELIZABETH HORTON HUTCHISON RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH ELIZABETH HORTON PA-C, RD

II. Dates (important events)

Enumeration Date: 12/09/2013
Last Update Date: 03/16/2020
Certification Date: 03/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 LEE ST
CHARLOTTESVILLE VA
22908-0509
US

IV. Provider business mailing address

PO BOX 801444
CHARLOTTESVILLE VA
22908-1444
US

V. Phone/Fax

Practice location:
  • Phone: 434-924-0000
  • Fax:
Mailing address:
  • Phone: 804-837-1601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: