Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | A005765 | AR |
N | 363LF0000X | Nurse Practitioner - Family Medicine | A005765 | AR |
NPI | 1023503869 |
---|---|
Provider Name | Katie J Hutton |
First Address | Jonesboro, AR 72404-7814 |
Second Address | Jonesboro, AR 72401-3104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2018 |
Last Update Date | 11/03/2019 |