Provider Demographics
NPI:1699539734
Name:MCCUTCHEN, JODY ANN (RN)
Entity type:Individual
Prefix:
First Name:JODY
Middle Name:ANN
Last Name:MCCUTCHEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 SARA MINNI DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612-2890
Mailing Address - Country:US
Mailing Address - Phone:585-233-1992
Mailing Address - Fax:
Practice Address - Street 1:42 SARA MINNI DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14612-2890
Practice Address - Country:US
Practice Address - Phone:585-233-1992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY526575163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy