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General NPI Number Information
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NPI Number | 1619443587
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Entity Type | Individual
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Provider Name | JACQUELYN HUTCHINGS FNP
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Gender | Female
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Dates
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Enumeration Date | 10/18/2018
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Last Update Date | 10/16/2019
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Provider Practice Location Address
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Address Line | 1619 NW HAWTHORNE AVE STE 204
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City | GRANTS PASS
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State | OR
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Zip | 97526-6009
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Country | US
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Telephone | 541-916-8530
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Fax | 541-916-8533
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Provider Business Mailing Address
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Address Line | 1625 SE N ST APT 202D
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City | GRANTS PASS
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State | OR
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Zip | 97526-4095
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Country | US
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Telephone | 541-941-2608
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201809553NP-PP
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License Number State | OR
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