Provider Demographics
NPI:1659869121
Name:HUTCHESON, SHANNA MARIE (RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:SHANNA
Middle Name:MARIE
Last Name:HUTCHESON
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15924 W 124TH CIR
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-4322
Mailing Address - Country:US
Mailing Address - Phone:913-221-6256
Mailing Address - Fax:
Practice Address - Street 1:11401 LAMAR AVE
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1508
Practice Address - Country:US
Practice Address - Phone:913-221-6256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-30
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered