Provider Demographics
NPI:1912425281
Name:HUTCHINSON, DEBORAH RENEE' (DCN)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:RENEE'
Last Name:HUTCHINSON
Suffix:
Gender:F
Credentials:DCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4803 MANGROVE POINT ROAD
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-2128
Mailing Address - Country:US
Mailing Address - Phone:843-864-5018
Mailing Address - Fax:
Practice Address - Street 1:4803 MANGROVE POINT RD
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-2128
Practice Address - Country:US
Practice Address - Phone:843-864-5018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10316133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist