Healthcare Provider Details

I. General information

NPI: 1265617153
Provider Name (Legal Business Name): ABIGAIL A HUTCHISON CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2008
Last Update Date: 06/29/2022
Certification Date: 06/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 SIXTH ST SW
CANTON OH
44710-1702
US

IV. Provider business mailing address

PO BOX 80690
CANTON OH
44708-0690
US

V. Phone/Fax

Practice location:
  • Phone: 330-452-9911
  • Fax:
Mailing address:
  • Phone: 330-833-5530
  • Fax: 330-833-6085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN305875
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: