Provider Demographics
NPI:1316510399
Name:HUTTON, MARK J (RN)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:J
Last Name:HUTTON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 WILLIAMSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLINVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08322-2559
Mailing Address - Country:US
Mailing Address - Phone:360-621-7563
Mailing Address - Fax:
Practice Address - Street 1:1260 WILLIAMSTOWN RD
Practice Address - Street 2:
Practice Address - City:FRANKLINVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08322-2559
Practice Address - Country:US
Practice Address - Phone:360-621-7563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-19
Last Update Date:2022-04-08
Deactivation Date:2021-12-08
Deactivation Code:
Reactivation Date:2022-04-08
Provider Licenses
StateLicense IDTaxonomies
NJ26NR2025500163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty