Provider Demographics
NPI:1134631450
Name:HATCHER, MEREDITH ROLLINS (PA-C)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:ROLLINS
Last Name:HATCHER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:RUTH
Other - Last Name:ROLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:204 S INTERSTATE I-35
Mailing Address - Street 2:SUITE 103
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628
Mailing Address - Country:US
Mailing Address - Phone:512-693-4041
Mailing Address - Fax:512-290-9226
Practice Address - Street 1:204 S INTERSTATE I-35
Practice Address - Street 2:SUITE 103
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628
Practice Address - Country:US
Practice Address - Phone:512-693-4041
Practice Address - Fax:512-290-9226
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-26
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPA11653363A00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant