Provider Demographics
NPI:1265820542
Name:HUTCHISON, HEATHER LAYNE
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:LAYNE
Last Name:HUTCHISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3017 N BOB YOUNKIN DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-3926
Mailing Address - Country:US
Mailing Address - Phone:479-463-8888
Mailing Address - Fax:479-463-8889
Practice Address - Street 1:3017 N BOB YOUNKIN DR
Practice Address - Street 2:SUITE 201
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-3926
Practice Address - Country:US
Practice Address - Phone:479-463-8888
Practice Address - Fax:479-463-8889
Is Sole Proprietor?:No
Enumeration Date:2015-01-08
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004264363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner