Healthcare Provider Details

I. General information

NPI: 1942187646
Provider Name (Legal Business Name): DANIEL J HUTCHERSON MSC, MA-GERO, CPG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2025
Last Update Date: 08/18/2025
Certification Date: 08/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 S 4TH ST STE 910
LOUISVILLE KY
40202-3439
US

IV. Provider business mailing address

401 S 4TH ST STE 910
LOUISVILLE KY
40202-3439
US

V. Phone/Fax

Practice location:
  • Phone: 502-371-9853
  • Fax:
Mailing address:
  • Phone: 502-371-9853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: