Provider Demographics
NPI:1871278580
Name:HYLTON, AUTUMN (CNP)
Entity type:Individual
Prefix:
First Name:AUTUMN
Middle Name:
Last Name:HYLTON
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:AUTUMN
Other - Middle Name:
Other - Last Name:DEEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6455 STATE ROUTE 95
Mailing Address - Street 2:
Mailing Address - City:MOUNT GILEAD
Mailing Address - State:OH
Mailing Address - Zip Code:43338-9407
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:314 AGLER RD STE B
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-2546
Practice Address - Country:US
Practice Address - Phone:614-284-4114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0034079363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner