Provider Demographics
NPI:1598372708
Name:KUTCHER, SANDRA KAY
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:KAY
Last Name:KUTCHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48945 N MARKET EXT
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-9120
Mailing Address - Country:US
Mailing Address - Phone:740-695-4181
Mailing Address - Fax:
Practice Address - Street 1:48945 N MARKET EXT
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-9120
Practice Address - Country:US
Practice Address - Phone:740-695-4181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care