Healthcare Provider Details

I. General information

NPI: 1912575044
Provider Name (Legal Business Name): MS. NATASHA DOMINIQUE HUTCHERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2021
Last Update Date: 06/15/2021
Certification Date: 06/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18111 INVERMERE AVE
CLEVELAND OH
44128-1629
US

IV. Provider business mailing address

5269 E 126TH ST APT 202
CLEVELAND OH
44125-3062
US

V. Phone/Fax

Practice location:
  • Phone: 614-214-1511
  • Fax:
Mailing address:
  • Phone: 614-214-1511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: