Healthcare Provider Details

I. General information

NPI: 1538950860
Provider Name (Legal Business Name): TABITHA FAITH HUTCHISON
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2025
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 LIBERTY VIEW LN
LYNCHBURG VA
24502-2291
US

IV. Provider business mailing address

1818 HATFIELD RD
HUNTINGTOWN MD
20639-9530
US

V. Phone/Fax

Practice location:
  • Phone: 434-592-6400
  • Fax:
Mailing address:
  • Phone: 443-975-9271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: