Provider Demographics
NPI:1124528187
Name:HUTCHINS, ARCHTRINA
Entity type:Individual
Prefix:
First Name:ARCHTRINA
Middle Name:
Last Name:HUTCHINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 CITRUS DR
Mailing Address - Street 2:
Mailing Address - City:FATE
Mailing Address - State:TX
Mailing Address - Zip Code:75189-4316
Mailing Address - Country:US
Mailing Address - Phone:601-597-8965
Mailing Address - Fax:
Practice Address - Street 1:216 CITRUS DR
Practice Address - Street 2:
Practice Address - City:FATE
Practice Address - State:TX
Practice Address - Zip Code:75189-4316
Practice Address - Country:US
Practice Address - Phone:601-597-8965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-16
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX199575164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse