Provider Demographics
NPI:1083073340
Name:HATCHER, NICOLE DANIELLE (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:DANIELLE
Last Name:HATCHER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MS
Other - First Name:NICOLE
Other - Middle Name:DANIELLE
Other - Last Name:MCCOY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1407 GLENN RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72076-8758
Mailing Address - Country:US
Mailing Address - Phone:501-580-2283
Mailing Address - Fax:501-771-7648
Practice Address - Street 1:119 W H AVE
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-8733
Practice Address - Country:US
Practice Address - Phone:501-772-3224
Practice Address - Fax:501-771-7648
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-15
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT4114225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist