Provider Demographics
NPI:1639538085
Name:HATCH SC ANESTHESIA LLC
Entity Type:Organization
Organization Name:HATCH SC ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE ANESTHETIST
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:HATCH
Authorized Official - Suffix:
Authorized Official - Credentials:MSNA, CRNA
Authorized Official - Phone:385-498-2281
Mailing Address - Street 1:3112 SE 22ND ST
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50021-9592
Mailing Address - Country:US
Mailing Address - Phone:385-498-2281
Mailing Address - Fax:
Practice Address - Street 1:3112 SE 22ND ST
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50021-9592
Practice Address - Country:US
Practice Address - Phone:385-498-2281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-14
Last Update Date:2016-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAD142703367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty