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General NPI Number Information
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NPI Number | 1801936513
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Entity Type | Individual
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Provider Name | TRISHA RENE HUTTON ACNP
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Gender | Female
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 940 E HATTIE GREENE
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-1918
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Country | US
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Telephone | 928-607-2607
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Fax |
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Provider Business Mailing Address
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Address Line | 940 E HATTIE GREENE
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-1918
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Country | US
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Telephone | 928-607-2607
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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 | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | RN094538
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License Number State | AZ
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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 | AP5442
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 209030762
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License Number State | IL
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