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NPI Code Detail

MEDICARE: DEANA L MCCUTCHEON CRNA

MEDICARE:   DEANA L MCCUTCHEON  CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist4704317883MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21104813021OTHERMINPI

General Provider Information

NPI Number : 1104813021
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEANA L MCCUTCHEON CRNA
Provider Business Mailing Address
First Line : 3211 DUDLEY AVE
Second Line :
City : PARKERSBURG
State : WV
Zip : 26104-1813
Country : US
Telephone Number : 304-422-3904
Fax Number : 304-422-3924
Provider Business Practice Location Address
First Line : 1701 SOUTH BLVD E STE 300
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48307-6120
Country : US
Telephone Number : 517-273-4695
Fax Number : 304-422-3924
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2005
Last Update Date : 03/07/2024

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Directions to “ DEANA L MCCUTCHEON CRNA” Practice Location

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