Healthcare Provider Details

I. General information

NPI: 1083039465
Provider Name (Legal Business Name): MR. ALLAN HUTCHESON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2014
Last Update Date: 02/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 S SYCAMORE ST
LITTLETON CO
80120-8201
US

IV. Provider business mailing address

4400 S MONACO ST APT.223
DENVER CO
80237-3446
US

V. Phone/Fax

Practice location:
  • Phone: 303-738-1021
  • Fax:
Mailing address:
  • Phone: 720-390-0665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number1625601
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: