Provider Demographics
NPI:1467808147
Name:HUTCHERSON, DAISY (CNA)
Entity Type:Individual
Prefix:
First Name:DAISY
Middle Name:
Last Name:HUTCHERSON
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10473 2ND ST
Mailing Address - Street 2:
Mailing Address - City:WHITE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32096-1951
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10473 2ND ST
Practice Address - Street 2:
Practice Address - City:WHITE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32096-1951
Practice Address - Country:US
Practice Address - Phone:386-234-9017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-11
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA143884376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide