Healthcare Provider Details

I. General information

NPI: 1164673661
Provider Name (Legal Business Name): CHARLOTTE ELIZABETH HUTCHESON CASE MANAGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2008
Last Update Date: 10/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2035 SAINT JOHN AVE
DYERSBURG TN
38024-2209
US

IV. Provider business mailing address

238 SUMMAR DR
JACKSON TN
38301-3906
US

V. Phone/Fax

Practice location:
  • Phone: 731-541-8344
  • Fax: 731-935-8327
Mailing address:
  • Phone: 731-541-8344
  • Fax: 731-935-8327

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: