Healthcare Provider Details

I. General information

NPI: 1497136766
Provider Name (Legal Business Name): DEANNE HUTCHINSON BHCM II/BHWC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2015
Last Update Date: 08/16/2024
Certification Date: 08/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 N MAIN ST
MUSKOGEE OK
74401-4431
US

IV. Provider business mailing address

619 N MAIN ST
MUSKOGEE OK
74401-4431
US

V. Phone/Fax

Practice location:
  • Phone: 918-682-8407
  • Fax: 918-913-3603
Mailing address:
  • Phone: 918-682-8407
  • Fax: 918-913-3603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: