Provider Demographics
NPI:1235462060
Name:HATCH, MICHAEL (LPN)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:HATCH
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 JOHN ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-1101
Mailing Address - Country:US
Mailing Address - Phone:781-388-6400
Mailing Address - Fax:978-275-6480
Practice Address - Street 1:35 JOHN ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-1101
Practice Address - Country:US
Practice Address - Phone:781-388-6400
Practice Address - Fax:978-275-6480
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-11
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA61158164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse