Provider Demographics
NPI:1508909409
Name:HUTCHINS, SHIRLEY (FNP)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:
Last Name:HUTCHINS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316 CRANE RD
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-8555
Mailing Address - Country:US
Mailing Address - Phone:704-243-4080
Mailing Address - Fax:
Practice Address - Street 1:1316 CRANE RD
Practice Address - Street 2:
Practice Address - City:WAXHAW
Practice Address - State:NC
Practice Address - Zip Code:28173-8555
Practice Address - Country:US
Practice Address - Phone:980-328-3770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2012-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200639363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCZF0000102Medicaid
NCZF0000102Medicaid