Provider Demographics
NPI:1669111068
Name:HUTTON, REBECCA RUTH (RN)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:RUTH
Last Name:HUTTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9763 FANCHER DR
Mailing Address - Street 2:
Mailing Address - City:HOUGHTON
Mailing Address - State:NY
Mailing Address - Zip Code:14744-8714
Mailing Address - Country:US
Mailing Address - Phone:585-567-2727
Mailing Address - Fax:
Practice Address - Street 1:9763 FANCHER DR
Practice Address - Street 2:
Practice Address - City:HOUGHTON
Practice Address - State:NY
Practice Address - Zip Code:14744-8714
Practice Address - Country:US
Practice Address - Phone:585-567-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY402423-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse