Provider Demographics
NPI:1841396363
Name:HUTCHISON, STEPHANIE A
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:A
Last Name:HUTCHISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:A
Other - Last Name:COVERDELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:825 S BUSINESS HIGHWAY 13
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:64067-1515
Mailing Address - Country:US
Mailing Address - Phone:816-249-2085
Mailing Address - Fax:660-251-0524
Practice Address - Street 1:608 MISSOURI ST
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:MO
Practice Address - Zip Code:64096-8241
Practice Address - Country:US
Practice Address - Phone:877-344-3572
Practice Address - Fax:866-288-4492
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO108949363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
P29439Medicare UPIN
P29439Medicare UPIN