Provider Demographics
NPI:1346592698
Name:HUTCHESON, KIM STOLPER
Entity Type:Individual
Prefix:MRS
First Name:KIM
Middle Name:STOLPER
Last Name:HUTCHESON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KIM
Other - Middle Name:DANIELLE
Other - Last Name:STOLPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:SCITUATE
Mailing Address - State:MA
Mailing Address - Zip Code:02066-2920
Mailing Address - Country:US
Mailing Address - Phone:339-933-2656
Mailing Address - Fax:
Practice Address - Street 1:11 10TH AVE
Practice Address - Street 2:
Practice Address - City:SCITUATE
Practice Address - State:MA
Practice Address - Zip Code:02066-2920
Practice Address - Country:US
Practice Address - Phone:339-933-2656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator