Provider Demographics
NPI:1659946895
Name:HUTCHINGS, KAYLENE MYA (DC)
Entity Type:Individual
Prefix:DR
First Name:KAYLENE
Middle Name:MYA
Last Name:HUTCHINGS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30001 VASSAR ST NE
Mailing Address - Street 2:
Mailing Address - City:NORTH BRANCH
Mailing Address - State:MN
Mailing Address - Zip Code:55056-6573
Mailing Address - Country:US
Mailing Address - Phone:651-470-7157
Mailing Address - Fax:
Practice Address - Street 1:6041 MAIN ST STE E
Practice Address - Street 2:
Practice Address - City:NORTH BRANCH
Practice Address - State:MN
Practice Address - Zip Code:55056-6595
Practice Address - Country:US
Practice Address - Phone:651-674-5040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6837111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor