Provider Demographics
NPI:1477649952
Name:HUTCHINSON, SUSAN H (APRN, BC)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:H
Last Name:HUTCHINSON
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:S
Other - Last Name:HARGROVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, BC
Mailing Address - Street 1:1928 ALCOA HWY
Mailing Address - Street 2:SUTIE 127
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1502
Mailing Address - Country:US
Mailing Address - Phone:865-305-8787
Mailing Address - Fax:865-305-8260
Practice Address - Street 1:1928 ALCOA HWY
Practice Address - Street 2:SUITE 127
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1502
Practice Address - Country:US
Practice Address - Phone:865-305-8787
Practice Address - Fax:865-305-8260
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000098739363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1502989Medicaid
TN3374013Medicare ID - Type Unspecified