Basic Information
| Provider Information | |||||||||
| NPI: | 1245873819 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JACQUELYN HUTCHINGS FNP, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1625 SE N ST APT 202D | ||||||||
| Address2: | |||||||||
| City: | GRANTS PASS | ||||||||
| State: | OR | ||||||||
| PostalCode: | 975264095 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1619 NW HAWTHORNE AVE STE 204 | ||||||||
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| City: | GRANTS PASS | ||||||||
| State: | OR | ||||||||
| PostalCode: | 975266009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5419168530 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2019 | ||||||||
| LastUpdateDate: | 10/25/2019 | ||||||||
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| AuthorizedOfficialLastName: | HUTCHINGS | ||||||||
| AuthorizedOfficialFirstName: | JACQUELYN | ||||||||
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| AuthorizedOfficialTitleorPosition: | FAMILY NURSE PRACTITIONER | ||||||||
| AuthorizedOfficialTelephone: | 5419412608 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |
No ID Information.