Provider Demographics
NPI:1821202672
Name:HUTCHINSON, KAY TAEKO (NP)
Entity Type:Individual
Prefix:
First Name:KAY
Middle Name:TAEKO
Last Name:HUTCHINSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2505
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-2505
Mailing Address - Country:US
Mailing Address - Phone:812-238-7783
Mailing Address - Fax:812-238-4506
Practice Address - Street 1:4001 WABASH AVE
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47803-1647
Practice Address - Country:US
Practice Address - Phone:812-238-7711
Practice Address - Fax:812-238-7700
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71002389A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00448376OtherRR MEDICARE
IN200861730Medicaid
IN252060C6Medicare PIN
IN130910JMedicare PIN
IN854700VVVVMedicare PIN
IN200861730Medicaid
IN941090V5Medicare PIN