Provider Demographics
NPI:1336493709
Name:HATCH, MONICA L (PA-C)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:L
Last Name:HATCH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2132 N 1700 W STE 200
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-7060
Mailing Address - Country:US
Mailing Address - Phone:801-776-0174
Mailing Address - Fax:801-825-3904
Practice Address - Street 1:2132 N 1700 W STE 200
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-7060
Practice Address - Country:US
Practice Address - Phone:801-776-0174
Practice Address - Fax:801-825-3904
Is Sole Proprietor?:No
Enumeration Date:2012-11-06
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5680506-1206363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical