MEDICARE: NANCY L HUTT FNP/ FAMILY PRACTICE

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	363LF0000X	Family Nurse Practitioner	200050059NP	OR

General Provider Information

NPI Number	:	1316911811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY L HUTT FNP/ FAMILY PRACTICE

Provider Business Mailing Address
First Line	:	1241 E DYER RD
Second Line	:	SUITE 145
City	:	SANTA ANA
State	:	CA
Zip	:	92705-5611
Country	:	US
Telephone Number	:	714-978-4533
Fax Number	:	714-368-0843

Provider Business Practice Location Address
First Line	:	1241 E DYER RD
Second Line	:	SUITE 145
City	:	SANTA ANA
State	:	CA
Zip	:	92705-5611
Country	:	US
Telephone Number	:	714-978-4533
Fax Number	:	714-368-0843

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

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	12/18/2014

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