Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | GAA-NP000264 | GA |
NPI | 1619546645 |
---|---|
Provider Name | Diana Hutchings |
First Address | Soddy Daisy, TN 37379-3477 |
Second Address | Dalton, GA 30720-2529 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2021 |
Last Update Date | 23/06/2021 |