Individual
MR. GENE C HUTSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1125 PUEBLO DR, LAKE HAVASU CITY, AZ 86406-8918
(928) 669-6669
Mailing address
PO BOX 813, LAKE HAVASU CITY, AZ 86405-0813
(928) 669-6669
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN114639
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP30004998
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
646995
AHCCCS
AZ
01
—
AP30004998
WA STATE
WA
Enumeration date
05/17/2006
Last updated
08/11/2020
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