Provider Demographics
NPI:1265911770
Name:HATCH, CATHY DARLENE
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:DARLENE
Last Name:HATCH
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 1:2122 CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-4430
Mailing Address - Country:US
Mailing Address - Phone:931-490-1480
Mailing Address - Fax:931-490-1482
Practice Address - Street 1:2122 CIRCLE DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4430
Practice Address - Country:US
Practice Address - Phone:931-490-1480
Practice Address - Fax:931-490-1482
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider