Basic Information
| Provider Information | |||||||||
| NPI: | 1558768150 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DUTCHER | ||||||||
| FirstName: | CAROLYN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1575 HIGHLANDS DR | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | LITITZ | ||||||||
| State: | PA | ||||||||
| PostalCode: | 175437507 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8883931338 | ||||||||
| FaxNumber: | 7176271817 | ||||||||
| Practice Location | |||||||||
| Address1: | 1575 HIGHLANDS DR | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | LITITZ | ||||||||
| State: | PA | ||||||||
| PostalCode: | 175437507 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8883931338 | ||||||||
| FaxNumber: | 7176271817 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/25/2014 | ||||||||
| LastUpdateDate: | 11/25/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WL0100X | RN590763 | PA | Y | Nursing Service Providers | Registered Nurse | Lactation Consultant |
No ID Information.