Basic Information
| Provider Information | |||||||||
| NPI: | 1184610966 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUTCHINGSON | ||||||||
| FirstName: | RANDY | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 119 KING ST | ||||||||
| Address2: | |||||||||
| City: | HAGERSTOWN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 217405732 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3016651717 | ||||||||
| FaxNumber: | 3016651810 | ||||||||
| Practice Location | |||||||||
| Address1: | 251 E ANTIETAM ST | ||||||||
| Address2: | |||||||||
| City: | HAGERSTOWN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 217405724 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3016651717 | ||||||||
| FaxNumber: | 3016651810 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | R094924 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.