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General NPI Number Information
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NPI Number | 1205632189
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Entity Type | Individual
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Provider Name | CASEN LANE HUTCHINSON NP-C
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Gender | Male
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Dates
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Enumeration Date | 02/21/2025
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 2080 S FRONTAGE RD STE 109
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City | VICKSBURG
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State | MS
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Zip | 39180-5882
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Country | US
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Telephone | 601-654-7070
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Fax | 601-696-6233
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Provider Business Mailing Address
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Address Line | PO BOX 1089
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City | HAMMOND
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State | LA
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Zip | 70404-1089
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Country | US
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Telephone | 985-892-7070
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Fax | 985-892-7017
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 918758
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 907719
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License Number State | MS
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