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Individual

TERESA DIANNE HUTSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
865 S 1ST ST, JESUP, GA 31545-0210
(912) 427-6811
(706) 660-9390
Mailing address
PO BOX 2585, COLUMBUS, GA 31902-2585
(706) 660-8505
(706) 660-9390

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN082039
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000558665C
GA
Enumeration date
11/22/2005
Last updated
01/28/2012
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