Provider Demographics
NPI:1710412077
Name:HATCHETT, JORDAN (MSN, WHNP-BC)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:HATCHETT
Suffix:
Gender:F
Credentials:MSN, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 776347
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6347
Mailing Address - Country:US
Mailing Address - Phone:270-404-5546
Mailing Address - Fax:
Practice Address - Street 1:315 E BROADWAY
Practice Address - Street 2:4TH FLOOR
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3700
Practice Address - Country:US
Practice Address - Phone:502-629-2500
Practice Address - Fax:502-629-2055
Is Sole Proprietor?:No
Enumeration Date:2017-04-25
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3011161363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000001085607OtherANTHEM
KY7100479480Medicaid
KYK236530OtherMEDICARE
KY228697OtherSIHO
IN300003650Medicaid
KY50128010OtherPASSPORT