Provider Demographics
NPI:1467949917
Name:HUTTON, LINDA (LVN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:HUTTON
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 POE ST
Mailing Address - Street 2:
Mailing Address - City:AZLE
Mailing Address - State:TX
Mailing Address - Zip Code:76020-2647
Mailing Address - Country:US
Mailing Address - Phone:817-991-8054
Mailing Address - Fax:
Practice Address - Street 1:821 POE ST
Practice Address - Street 2:
Practice Address - City:AZLE
Practice Address - State:TX
Practice Address - Zip Code:76020-2647
Practice Address - Country:US
Practice Address - Phone:817-991-8054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68311164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse