Healthcare Provider Details

I. General information

NPI: 1013762426
Provider Name (Legal Business Name): TINA M HUTCHINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2024
Last Update Date: 04/19/2024
Certification Date: 04/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9688 TRUAX RD
VASSAR MI
48768-9466
US

IV. Provider business mailing address

9688 TRUAX RD
VASSAR MI
48768-9466
US

V. Phone/Fax

Practice location:
  • Phone: 989-928-2154
  • Fax:
Mailing address:
  • Phone: 989-928-2154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: