Provider Demographics
NPI:1275783409
Name:O'SHEA HUTCHINS, SUMMER (CARE COORDINATOR)
Entity Type:Individual
Prefix:MS
First Name:SUMMER
Middle Name:
Last Name:O'SHEA HUTCHINS
Suffix:
Gender:F
Credentials:CARE COORDINATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E SWANSON AVE STE 13
Mailing Address - Street 2:POBOX 298222
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7054
Mailing Address - Country:US
Mailing Address - Phone:907-376-1922
Mailing Address - Fax:907-376-1925
Practice Address - Street 1:201 E SWANSON AVE STE 13
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654
Practice Address - Country:US
Practice Address - Phone:907-376-1922
Practice Address - Fax:907-376-1925
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator