DR. KELLI ANN HUTCHENS (NPI# 1578726717) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578726717 |
| Entity Type | Individual |
| Full Name | DR. KELLI ANN HUTCHENS |
| Credential | M.D. |
| Practice Address |
801 York St Manitowoc WI 54220-4630 |
| Practice Telephone | 9206835278 |
| Practice Fax Number | 9206869674 |
| Mailing Telephone | 9206639008 |
| Mailing Fax Number | 9206841439 |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2020-05-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ND0900X |
Dermatology Specialization: Dermatopathology |
65468-20 | WI | Allopathic & Osteopathic Physicians |
| Y | 207ZD0900X |
Pathology Specialization: Dermatopathology |
65468-20 | WI | Allopathic & Osteopathic Physicians |
| N | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
65468-20 | WI | Allopathic & Osteopathic Physicians |
| Street Address |
801 YORK ST |
| City | MANITOWOC |
| State | WI |
| Zip Code | 54220-4630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932101060 | Kyung Ai Mireille Chae | Dermatology | 801 York St, Manitowoc, WI 54220-4630 | 2005-06-01 |
| 1487969507 | Forefront Dermatology, S.c. | Dermatology | 801 York St, Manitowoc, WI 54220 | 2010-08-12 |
| 1053502005 | Sapna Patel Vaghani | Dermatology | 801 York St, Manitowoc, WI 54220-4630 | 2007-08-06 |
| 1457554917 | Willmar Davison Patino Cadavid | Dermatology | 801 York St, Manitowoc, WI 54220-4630 | 2007-06-11 |
| 1972669083 | David Earl Hammond | Dermatology | 801 York St, Manitowoc, WI 54220-4630 | 2007-01-01 |
| 1932209129 | Ling Xia | Dermatology | 801 York St, Manitowoc, WI 54220-4630 | 2006-09-25 |
| 1912944752 | Song Qing Zhao | Pathology | 801 York St, Manitowoc, WI 54220 | 2006-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235614843 | Katherine Borchardt | Registered Nurse | 3520 Foxfire Ct, Manitowoc, WI 54220 | 2018-09-28 |
| 1285128215 | Aurora Pharmacy Inc | Pharmacy | 3509 Dewey Street, Suite 100, Manitowoc, WI 54220 | 2018-06-22 |
| 1477937274 | Baycare Clinic LLP | Psychiatry & Neurology | 4801 Expo Drive, Manitowoc, WI 54220 | 2015-07-13 |
| 1831593821 | Brittany Camille Schultz | Acupuncturist | 2510 Washington Street, Manitowoc, WI 54220 | 2014-10-20 |
| 1710311261 | Brian E Weitz | Physical Therapy Assistant | 960 S. Rapids Rd., Manitowoc, WI 54220 | 2013-09-01 |
| 1134499080 | Total Renal Care Inc | Clinic/Center | 3303 Dewey St, Manitowoc, WI 54220 | 2012-01-10 |
| 1679858534 | Lisa M Noworatzky | Marriage & Family Therapist | 926 S. 8th St., Manitowoc, WI 54220 | 2011-10-11 |
| 1306177225 | Cynthia Fay Wenzel | Licensed Practical Nurse | 915 East Linden Avenue, Manitowoc, WI 54220 | 2010-01-15 |
| 1851550628 | Roundys Supermarkets Inc | Pharmacy | 3300 Calumet Ave, Manitowoc, WI 54220 | 2008-06-05 |
| 1851566079 | Jennifer C Mcwilliams | Registered Nurse | 1004 Nth 8th St., Manitowoc, WI 54220 | 2008-04-29 |
| Find all providers in zip 54220 | ||||
| Taxonomy Code | 207ZD0900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Dermatopathology |
| A dermatopathologist is an expert in diagnosing and monitoring diseases of the skin including infectious, immunologic, degenerative, and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings, and smears of skin lesions by means of light microscopy, electron microscopy, and fluorescence microscopy. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source added] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. A subspecialty certificate was first issued by the ABMS in 1974. ACGME Accredited Residency Program Requirements: None. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912944752 | Song Qing Zhao | Pathology | 801 York St, Manitowoc, WI 54220 | 2006-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003076142 | Shanon Renee Lacy | Pathology | 8901 W Lincoln Ave, West Allis, WI 53227-2409 | 2008-06-12 |
| 1881734028 | Cris Patrick Myers | Pathology | 1969 W Hart Rd, Beloit, WI 53511-2230 | 2007-02-07 |
| 1881796001 | Chafik Bengana | Pathology | 2323 N Lake Dr, Milwaukee, WI 53211-4508 | 2006-09-01 |
| 1841255122 | Andrew R Virata | Pathology | 1400 Bellinger St, Eau Claire, WI 54703-5222 | 2006-04-19 |
| 1922063239 | Sarah R Hughes | Pathology | 1836 South Ave, La Crosse, WI 54601-5429 | 2006-04-19 |
| 1700863685 | Scott W. Kelley | Pathology | 12805 W Burleigh Rd, Suite 200, Brookfield, WI 53005-3111 | 2005-12-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.