Provider Demographics
NPI:1326839648
Name:HUTT, JAMIE (NP STUDENT)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:HUTT
Suffix:
Gender:F
Credentials:NP STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5117 E SOFTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83716-8634
Mailing Address - Country:US
Mailing Address - Phone:503-267-6192
Mailing Address - Fax:
Practice Address - Street 1:4888 W AERONCA ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-5056
Practice Address - Country:US
Practice Address - Phone:503-678-4374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID42357163WF0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WF0300XNursing Service ProvidersRegistered NurseFlight