Provider Demographics
NPI:1326333808
Name:HUTCHINSON, SUSAN (LPN)
Entity Type:Individual
Prefix:MISS
First Name:SUSAN
Middle Name:
Last Name:HUTCHINSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11828 JACKSON CIR
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80233-1628
Mailing Address - Country:US
Mailing Address - Phone:210-393-0923
Mailing Address - Fax:
Practice Address - Street 1:11828 JACKSON CIR
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80233-1628
Practice Address - Country:US
Practice Address - Phone:210-393-0923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO46016164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse