Provider Demographics
NPI:1134103278
Name:HUTTON, KARA M (APRN, FNP)
Entity Type:Individual
Prefix:MS
First Name:KARA
Middle Name:M
Last Name:HUTTON
Suffix:
Gender:F
Credentials:APRN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 WATER ST
Mailing Address - Street 2:
Mailing Address - City:EXCELSIOR
Mailing Address - State:MN
Mailing Address - Zip Code:55331-3072
Mailing Address - Country:US
Mailing Address - Phone:952-906-7855
Mailing Address - Fax:952-470-4523
Practice Address - Street 1:675 WATER ST
Practice Address - Street 2:
Practice Address - City:EXCELSIOR
Practice Address - State:MN
Practice Address - Zip Code:55331-3072
Practice Address - Country:US
Practice Address - Phone:952-906-7855
Practice Address - Fax:952-470-4523
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR122257-3363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
F51316Medicare UPIN