Provider Demographics
NPI:1821639774
Name:HUTCHINSON CLINIC, PA, INC.
Entity Type:Organization
Organization Name:HUTCHINSON CLINIC, PA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:NAGENGAST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-694-4194
Mailing Address - Street 1:2101 N WALDRON ST
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-1197
Mailing Address - Country:US
Mailing Address - Phone:620-694-4194
Mailing Address - Fax:620-694-2128
Practice Address - Street 1:2101 N WALDRON ST
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-1197
Practice Address - Country:US
Practice Address - Phone:620-694-4194
Practice Address - Fax:620-694-2128
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUTCHINSON CLINIC P A INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-10-02
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes EducatorGroup - Multi-Specialty