Provider Demographics
NPI:1679324164
Name:HUTTO, ESTHER
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:
Last Name:HUTTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 BARCLAY CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-7037
Mailing Address - Country:US
Mailing Address - Phone:803-250-9128
Mailing Address - Fax:
Practice Address - Street 1:1717 NEARVIEW AVE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-3614
Practice Address - Country:US
Practice Address - Phone:803-250-9128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC227048163W00000X
310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No163W00000XNursing Service ProvidersRegistered Nurse