Individual
MRS. SHANA DANIELLE HUTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
454 VERNON WILLIAMS RD, HAZLEHURST, GA 31539-7887
(912) 750-8801
(912) 705-8851
Mailing address
210 HILLSBORO RD, LYONS, GA 30436-4646
(912) 245-1577
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN170590
GA
Other
Enumeration date
06/14/2018
Last updated
06/30/2021
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