Provider Demographics
NPI:1750823290
Name:HUTCHINSON, LUKE
Entity type:Individual
Prefix:
First Name:LUKE
Middle Name:
Last Name:HUTCHINSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 S SHIELDS ST
Mailing Address - Street 2:APT C-8
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-5657
Mailing Address - Country:US
Mailing Address - Phone:570-862-1085
Mailing Address - Fax:
Practice Address - Street 1:1805 S SHIELDS ST
Practice Address - Street 2:APT C-8
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-5657
Practice Address - Country:US
Practice Address - Phone:570-862-1085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO421607042282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO421607042OtherKAISER PERMANENTE