Provider Demographics
NPI:1275897399
Name:HATTER, MELISSA (CNM)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:HATTER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 LINDSAY CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-2174
Mailing Address - Country:US
Mailing Address - Phone:205-826-7143
Mailing Address - Fax:
Practice Address - Street 1:2300 MANCHESTER EXPY STE B001
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-6877
Practice Address - Country:US
Practice Address - Phone:706-324-4891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-03
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-129-329163W00000X, 367A00000X
GARN263129163W00000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse