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General NPI Number Information
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NPI Number | 1245461508
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Entity Type | Individual
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Provider Name | CLARENCE MICHAEL HUTTO NP
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Gender | Male
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Dates
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Enumeration Date | 08/05/2009
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 125 BAPTIST WAY STE 3C
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City | PENSACOLA
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State | FL
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Zip | 32503-2274
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Country | US
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Telephone | 448-227-6500
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Fax | 850-857-1747
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Provider Business Mailing Address
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Address Line | 1005 MAR WALT DRIVE IMMEDIATE CARE DEPARTMENT
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-6796
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Country | US
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Telephone | 850-863-8219
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Fax | 850-863-8249
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP9171115
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License Number State | FL
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