Healthcare Provider Details
I. General information
NPI: 1659164655
Provider Name (Legal Business Name): CHRISTOPHER DANIEL KUTCHES FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/23/2025
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1381 UNIVERSITY ST
HEALDSBURG CA
95448-3314
US
IV. Provider business mailing address
7743 FOPPIANO WAY
WINDSOR CA
95492-7701
US
V. Phone/Fax
- Phone: 707-433-5494
- Fax:
- Phone: 707-217-3882
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WH1000X |
| Taxonomy | Hospice Registered Nurse |
| License Number | 764558 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 95035838 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: