Provider Demographics
NPI:1457028730
Name:HUTSON, JAMIE (RN)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:HUTSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 LOCUST AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-4721
Mailing Address - Country:US
Mailing Address - Phone:304-363-7323
Mailing Address - Fax:304-366-2483
Practice Address - Street 1:71 UTT DR
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:WV
Practice Address - Zip Code:26354-7449
Practice Address - Country:US
Practice Address - Phone:304-363-7323
Practice Address - Fax:304-366-2483
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV60839163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool