Provider Demographics
NPI:1336914530
Name:HUTCHINSON-WINTJE, NICODIA (NP)
Entity Type:Individual
Prefix:
First Name:NICODIA
Middle Name:
Last Name:HUTCHINSON-WINTJE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:NICODIA
Other - Middle Name:
Other - Last Name:HUTCHINSON-WINTJE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 180539
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-0539
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:520 E 21ST ST APT 5G
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-6845
Practice Address - Country:US
Practice Address - Phone:646-436-9004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY421685363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health