Provider Demographics
NPI:1477431690
Name:KUTCHBACK, CAROLYN PAIGE (RN)
Entity type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:PAIGE
Last Name:KUTCHBACK
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 1:16915 SW 93RD ST APT 13-220
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-1008
Mailing Address - Country:US
Mailing Address - Phone:636-459-7050
Mailing Address - Fax:
Practice Address - Street 1:16915 SW 93RD ST APT 13-220
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-1008
Practice Address - Country:US
Practice Address - Phone:636-459-7050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9680830163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine