Provider Demographics
NPI:1912575044
Name:HUTCHERSON, NATASHA DOMINIQUE
Entity Type:Individual
Prefix:MS
First Name:NATASHA
Middle Name:DOMINIQUE
Last Name:HUTCHERSON
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 1:5269 E 126TH ST APT 202
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44125-3062
Mailing Address - Country:US
Mailing Address - Phone:614-214-1511
Mailing Address - Fax:
Practice Address - Street 1:18111 INVERMERE AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-1629
Practice Address - Country:US
Practice Address - Phone:614-214-1511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide