MEDICARE: LORRAE LYNN HUTCHINSON HOME HEALTH AIDE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1164099537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORRAE LYNN HUTCHINSON HOME HEALTH AIDE

Provider Business Mailing Address
First Line	:	10155 BAMMEL NORTH HOUSTON RD APT 101
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77086-2960
Country	:	US
Telephone Number	:	515-718-1384
Fax Number	:

Provider Business Practice Location Address
First Line	:	10155 BAMMEL NORTH HOUSTON RD APT 101
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77086-2960
Country	:	US
Telephone Number	:	515-718-1384
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2021
Last Update Date	:	06/10/2021

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