Healthcare Provider Details

I. General information

NPI: 1639923527
Provider Name (Legal Business Name): CHRISTINA DALEY HUTCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2024
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1577 NEIL AVE
COLUMBUS OH
43201-2320
US

IV. Provider business mailing address

934 HUDSON XING
COLUMBUS OH
43212-3944
US

V. Phone/Fax

Practice location:
  • Phone: 614-292-4041
  • Fax:
Mailing address:
  • Phone: 330-720-5813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN.416370
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: