Provider Demographics
NPI:1194149765
Name:HUTHER, DANIEL L
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:L
Last Name:HUTHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 VEACH RD
Mailing Address - Street 2:STE 3
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-8800
Mailing Address - Country:US
Mailing Address - Phone:270-684-5005
Mailing Address - Fax:
Practice Address - Street 1:2900 VEACH RD
Practice Address - Street 2:STE 3
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-8800
Practice Address - Country:US
Practice Address - Phone:270-684-5005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-18
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3008517367500000X
IN28165587A367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered