Provider Demographics
NPI:1891981676
Name:HUTSON, RACHEL MICHELLE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:MICHELLE
Last Name:HUTSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:MICHELLE
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:20485 NESS RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:KS
Mailing Address - Zip Code:66733-5052
Mailing Address - Country:US
Mailing Address - Phone:316-640-6105
Mailing Address - Fax:
Practice Address - Street 1:629 S PLUMMER AVE
Practice Address - Street 2:
Practice Address - City:CHANUTE
Practice Address - State:KS
Practice Address - Zip Code:66720-1928
Practice Address - Country:US
Practice Address - Phone:620-431-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-14
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-01179363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant