Provider Demographics
NPI:1295057677
Name:DUTSON, ROXIANNE (RN, CPM)
Entity type:Individual
Prefix:
First Name:ROXIANNE
Middle Name:
Last Name:DUTSON
Suffix:
Gender:F
Credentials:RN, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1065 NORTH HILDALE STREET #459
Mailing Address - Street 2:PO BOX 840459
Mailing Address - City:HILDALE
Mailing Address - State:UT
Mailing Address - Zip Code:84784-0459
Mailing Address - Country:US
Mailing Address - Phone:435-874-2217
Mailing Address - Fax:435-874-7807
Practice Address - Street 1:1065 NORTH HILDALE STREET #459
Practice Address - Street 2:
Practice Address - City:HILDALE
Practice Address - State:UT
Practice Address - Zip Code:84784-0459
Practice Address - Country:US
Practice Address - Phone:435-874-2217
Practice Address - Fax:435-874-7807
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT268145-3400176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife