Provider Demographics
NPI:1710638069
Name:HUTCHENS, CHAD ROBERT (RN)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:ROBERT
Last Name:HUTCHENS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 E SLAUGHTER LN APT 2210
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78744-2147
Mailing Address - Country:US
Mailing Address - Phone:219-265-3249
Mailing Address - Fax:
Practice Address - Street 1:515 E SLAUGHTER LN APT 2210
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78744-2147
Practice Address - Country:US
Practice Address - Phone:219-265-3249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-18
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX980964163WE0003X, 363L00000X
TX1111524363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily