Provider Demographics
NPI:1417394727
Name:HUTCHISON, LORIE (PA-C)
Entity Type:Individual
Prefix:
First Name:LORIE
Middle Name:
Last Name:HUTCHISON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PMB 133 PO BOX 10001
Mailing Address - Street 2:
Mailing Address - City:SAIPAN
Mailing Address - State:MP
Mailing Address - Zip Code:96950
Mailing Address - Country:US
Mailing Address - Phone:670-236-8269
Mailing Address - Fax:670-236-8269
Practice Address - Street 1:1 LOWER NAVY HILL ROAD
Practice Address - Street 2:NAVY HILL
Practice Address - City:SAIPAN
Practice Address - State:MP
Practice Address - Zip Code:96950
Practice Address - Country:US
Practice Address - Phone:670-236-8201
Practice Address - Fax:670-236-8756
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-28
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT201586-1206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant