Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 016.0120271 | VT |
Y | 213EG0000X | General Practice | 016.0120271 | VT |
NPI | 1003263385 |
---|---|
Provider Name | Dr. Jessica Lauren Hacker Hutchins |
First Address | Essex Junction, VT 05452-2940 |
Second Address | Essex Junction, VT 05452-2940 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2016 |
Last Update Date | 27/09/2019 |