Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 4301051148 | MI |
NPI | 1003039199 |
---|---|
Provider Name | Dr. Julie Ann Hutson |
First Address | Holland, MI 49424 |
Second Address | Holland, MI 49424-8047 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 22/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4604806 | (05) | MI |
F07594 | (02) | MI |