Healthcare Provider Details

I. General information

NPI: 1154281293
Provider Name (Legal Business Name): MS. GLENDA FAYE HUTCHINS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2025
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 GENESIS WAY APT 317
DAYTON OH
45417-8474
US

IV. Provider business mailing address

202 GLENSIDE CT
DAYTON OH
45426-2734
US

V. Phone/Fax

Practice location:
  • Phone: 937-341-3000
  • Fax: 937-341-3005
Mailing address:
  • Phone: 937-341-3000
  • Fax: 937-341-3005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberT2025U2
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: