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NPI Code Detail

MEDICARE: AUDREY HUTCHISON

MEDICARE: AUDREY HUTCHISON
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
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1477105476
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUDREY HUTCHISON
Provider Business Mailing Address
First Line : 1824 S VAN BUREN ST
Second Line :
City : ENID
State : OK
Zip : 73703-7903
Country : US
Telephone Number : 580-540-8965
Fax Number :
Provider Business Practice Location Address
First Line : 1824 S VAN BUREN ST
Second Line :
City : ENID
State : OK
Zip : 73703-7903
Country : US
Telephone Number : 580-540-8965
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2019
Last Update Date : 07/10/2019

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Directions to “ AUDREY HUTCHISON ” Practice Location

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