Provider Demographics
NPI:1639583834
Name:HUTCHENS, JULIE KAYLAN (APRN)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:KAYLAN
Last Name:HUTCHENS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:19 MEDICAL PLZ STE 40
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-2962
Mailing Address - Country:US
Mailing Address - Phone:870-232-5215
Mailing Address - Fax:870-232-5240
Practice Address - Street 1:140 HIGHWAY 201 N
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-3158
Practice Address - Country:US
Practice Address - Phone:870-232-5215
Practice Address - Fax:870-232-5240
Is Sole Proprietor?:No
Enumeration Date:2014-06-16
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004102363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR207702758Medicaid