Provider Demographics
NPI:1215434956
Name:TUTSON, MARAEA (RN, CM)
Entity type:Individual
Prefix:
First Name:MARAEA
Middle Name:
Last Name:TUTSON
Suffix:
Gender:F
Credentials:RN, CM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2640 COLLEGEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-1745
Mailing Address - Country:US
Mailing Address - Phone:248-595-0322
Mailing Address - Fax:248-595-0322
Practice Address - Street 1:3200 GREENFIELD RD STE 300
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48120-1805
Practice Address - Country:US
Practice Address - Phone:248-595-0322
Practice Address - Fax:248-595-0322
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704310539163W00000X, 171400000X, 374U00000X, 376K00000X
MI20352073231163WC1500X, 163WC1600X, 163WI0600X, 163WP0000X, 163WP0200X, 3747A0650X, 163WC0400X
MI30352073231163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WI0600XNursing Service ProvidersRegistered NurseInfection Control
No163WP0000XNursing Service ProvidersRegistered NursePain Management
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
No171400000XOther Service ProvidersHealth & Wellness Coach
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide