Provider Demographics
NPI:1184377004
Name:HUTCHISON, CHARLENE
Entity type:Individual
Prefix:
First Name:CHARLENE
Middle Name:
Last Name:HUTCHISON
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 1:20913 LINGREL RD
Mailing Address - Street 2:
Mailing Address - City:WEST MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:43358-9613
Mailing Address - Country:US
Mailing Address - Phone:937-303-2756
Mailing Address - Fax:
Practice Address - Street 1:20913 LINGREL RD
Practice Address - Street 2:
Practice Address - City:WEST MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:43358-9613
Practice Address - Country:US
Practice Address - Phone:937-303-2756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-31
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No347C00000XTransportation ServicesPrivate Vehicle