Provider Demographics
NPI:1710957709
Name:HATCHETT, KELLEY
Entity Type:Individual
Prefix:
First Name:KELLEY
Middle Name:
Last Name:HATCHETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 557 BOX 1640
Mailing Address - Street 2:BLDG 26 APT 703 CAMP FOSTER
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96379
Mailing Address - Country:US
Mailing Address - Phone:611-746-2228
Mailing Address - Fax:
Practice Address - Street 1:PSC 557 BOX 1640
Practice Address - Street 2:US NAVAL HOSPITAL-OKINAWA
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96379
Practice Address - Country:US
Practice Address - Phone:611-746-2228
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12095183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist