Individual
MS. BEVERLY CRANDELL HUTCHINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, BC
Contact information
Practice address
325 E H ST, IRON MOUNTAIN, MI 49801
(906) 774-3300
Mailing address
325 E H ST, IRON MOUNTAIN, MI 49801-4760
(906) 774-3300
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704142802
MI
164W00000X
Licensed Practical Nurse
4704142802
MI
363L00000X
Nurse Practitioner
2005010462
MI
363LF0000X
Family Nurse Practitioner
Primary
4704142802
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300207909
TAX ID
MI
05
—
4845354
—
MI
Enumeration date
07/17/2006
Last updated
12/07/2018
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