Basic Information
Provider Information
NPI: 1952863102
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAHN HUTCHINS
FirstName: JESSICA
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HAHN
OtherFirstName: JESSICA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 38135 MARKET SQ
Address2:  
City: ZEPHYRHILLS
State: FL
PostalCode: 335427539
CountryCode: US
TelephoneNumber: 8132807676
FaxNumber: 8133555098
Practice Location
Address1: 14547 BRUCE B DOWNS BLVD STE B
Address2:  
City: TAMPA
State: FL
PostalCode: 336132709
CountryCode: US
TelephoneNumber: 8132807676
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/04/2019
LastUpdateDate: 04/25/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAPRN9334285FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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