Provider Demographics
NPI:1700048402
Name:WEST-HUTCHINS, TANYA JEANNINE (NP)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:JEANNINE
Last Name:WEST-HUTCHINS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 GATEWAY BLVD N
Mailing Address - Street 2:
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-9658
Mailing Address - Country:US
Mailing Address - Phone:219-921-1444
Mailing Address - Fax:219-921-0533
Practice Address - Street 1:9730 S WESTERN AVE STE 700
Practice Address - Street 2:
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-2814
Practice Address - Country:US
Practice Address - Phone:708-425-1907
Practice Address - Fax:708-422-4358
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28110088A163W00000X
IN71002691A363LF0000X
IL209007601363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200930450Medicaid
IN200930450Medicaid
IN151020FFFFMedicare PIN