Hutto, Clarence Michael

Hutto, Clarence Michael is an individual health care provider with primary practice located at 1005 Mar Walt Drive Immediate Care Department, Fort Walton Beach FL 32547-6796. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Hutto, Clarence Michael can be contacted via phone (850) 863-8219.

Contact Information

Primary practice address
1005 Mar Walt Drive Immediate Care Department Fort Walton Beach FL 32547-6796
Phone: (850) 863-8219
Fax: (850) 863-8249
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP9171115 Florida

Profile Details

NPI number 1245461508
LBN Legal business name Hutto, Clarence Michael
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 2009
Last updated Jan 17th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245461508 NPPES
Florida MEDICAID 010403200
Florida Other Y0KS7

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