MEDICARE: PAMELA J. HUTCHESON FNP

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	536412	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00300685	OTHER	TX	MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871535211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA J. HUTCHESON FNP

Provider Business Mailing Address
First Line	:	5440 HARVEST HILL RD STE 182B
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-1607
Country	:	US
Telephone Number	:	214-738-3908
Fax Number	:	214-614-6148

Provider Business Practice Location Address
First Line	:	5440 HARVEST HILL RD STE 182B
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-1607
Country	:	US
Telephone Number	:	214-738-3908
Fax Number	:	214-614-6148

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

Provider Enumeration Date	:	06/11/2006
Last Update Date	:	01/25/2019

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