Provider Demographics
NPI:1467833608
Name:HUTTO, DAPHNE (CRNP)
Entity Type:Individual
Prefix:
First Name:DAPHNE
Middle Name:
Last Name:HUTTO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4507 HOSPITAL ST
Mailing Address - Street 2:
Mailing Address - City:PASCAGOULA
Mailing Address - State:MS
Mailing Address - Zip Code:39581-5336
Mailing Address - Country:US
Mailing Address - Phone:228-769-1940
Mailing Address - Fax:228-769-9231
Practice Address - Street 1:4507 HOSPITAL ST
Practice Address - Street 2:
Practice Address - City:PASCAGOULA
Practice Address - State:MS
Practice Address - Zip Code:39581-5336
Practice Address - Country:US
Practice Address - Phone:228-769-1940
Practice Address - Fax:228-769-9231
Is Sole Proprietor?:No
Enumeration Date:2015-06-13
Last Update Date:2015-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR886161363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health