Provider Demographics
NPI:1770276107
Name:HUTCHESON, ELYSE FRANCES
Entity type:Individual
Prefix:
First Name:ELYSE
Middle Name:FRANCES
Last Name:HUTCHESON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2819 NORTHWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-3764
Mailing Address - Country:US
Mailing Address - Phone:484-319-6864
Mailing Address - Fax:
Practice Address - Street 1:2610 W LIBERTY ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-6560
Practice Address - Country:US
Practice Address - Phone:734-368-9691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program