Provider Demographics
NPI:1013179696
Name:HUTCHINS, KATHRYN ELLEN (MD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ELLEN
Last Name:HUTCHINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:ELLEN
Other - Last Name:LAZURE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:988102 NEBRASKA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-8102
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:110 N. 175TH ST
Practice Address - Street 2:SUITE 2000
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68118-0001
Practice Address - Country:US
Practice Address - Phone:402-559-4015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE25487207RG0100X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology