Provider Demographics
NPI:1457836298
Name:HATCH, AIMEE (NP-C)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:HATCH
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1471 STATE HWY E
Mailing Address - Street 2:
Mailing Address - City:COOTER
Mailing Address - State:MO
Mailing Address - Zip Code:63839
Mailing Address - Country:US
Mailing Address - Phone:870-780-4777
Mailing Address - Fax:
Practice Address - Street 1:527 N 6TH ST
Practice Address - Street 2:
Practice Address - City:BLYTHEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72315-2407
Practice Address - Country:US
Practice Address - Phone:870-762-5260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018032675363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner