Provider Demographics
NPI:1831891902
Name:HUTCHISON, JUANITA MICHELLE
Entity type:Individual
Prefix:
First Name:JUANITA
Middle Name:MICHELLE
Last Name:HUTCHISON
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:PO BOX 371
Mailing Address - Street 2:
Mailing Address - City:BEACH
Mailing Address - State:ND
Mailing Address - Zip Code:58621-0371
Mailing Address - Country:US
Mailing Address - Phone:406-359-9733
Mailing Address - Fax:
Practice Address - Street 1:259 1ST. AVE NW
Practice Address - Street 2:
Practice Address - City:BEACH
Practice Address - State:ND
Practice Address - Zip Code:58621
Practice Address - Country:US
Practice Address - Phone:406-359-9733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant