Provider Demographics
NPI:1861842098
Name:STUTLER, HANNAH REBECCA
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:REBECCA
Last Name:STUTLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 KINGS RD
Mailing Address - Street 2:
Mailing Address - City:QUINBY
Mailing Address - State:SC
Mailing Address - Zip Code:29506-7414
Mailing Address - Country:US
Mailing Address - Phone:843-317-4073
Mailing Address - Fax:
Practice Address - Street 1:125 E CHEVES ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2526
Practice Address - Country:US
Practice Address - Phone:843-317-4073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-19
Last Update Date:2016-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator