Provider Demographics
NPI:1871460287
Name:HUTCHINSON-PROVINCE, KATRINA
Entity type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:
Last Name:HUTCHINSON-PROVINCE
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 1:1447 E 84TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-5127
Mailing Address - Country:US
Mailing Address - Phone:347-760-2242
Mailing Address - Fax:
Practice Address - Street 1:1447 E 84TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-5127
Practice Address - Country:US
Practice Address - Phone:347-760-2242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-21
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY780087163WP2201X, 163WI0500X, 163WC1500X, 163WH0200X, 163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical