Provider Demographics
NPI:1154633139
Name:HATCH, NIGELLE VATINA (LPN)
Entity Type:Individual
Prefix:MS
First Name:NIGELLE
Middle Name:VATINA
Last Name:HATCH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14925 WINTHROP ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48227-4105
Mailing Address - Country:US
Mailing Address - Phone:313-478-6885
Mailing Address - Fax:
Practice Address - Street 1:2850 S INDUSTRIAL HWY
Practice Address - Street 2:SUITE 75
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-6796
Practice Address - Country:US
Practice Address - Phone:734-477-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703059416164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse