Provider Demographics
NPI:1558594556
Name:HATCH, BRIDGETT L (RN)
Entity Type:Individual
Prefix:MISS
First Name:BRIDGETT
Middle Name:L
Last Name:HATCH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 SHAWNEE RUN
Mailing Address - Street 2:APT. D
Mailing Address - City:WEST CARROLLTON
Mailing Address - State:OH
Mailing Address - Zip Code:45449-3954
Mailing Address - Country:US
Mailing Address - Phone:937-859-4672
Mailing Address - Fax:
Practice Address - Street 1:420 SHAWNEE RUN
Practice Address - Street 2:APT. D
Practice Address - City:WEST CARROLLTON
Practice Address - State:OH
Practice Address - Zip Code:45449-3954
Practice Address - Country:US
Practice Address - Phone:937-369-4521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-25
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH132992164W00000X
OH365834163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse