Provider Demographics
NPI:1295135796
Name:HATCH, CAROLYN C (PA-C)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:C
Last Name:HATCH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1120 FIRST COLONIAL RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-2418
Mailing Address - Country:US
Mailing Address - Phone:757-481-2333
Mailing Address - Fax:757-481-1037
Practice Address - Street 1:1120 FIRST COLONIAL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-2418
Practice Address - Country:US
Practice Address - Phone:757-481-2333
Practice Address - Fax:757-481-1037
Is Sole Proprietor?:No
Enumeration Date:2014-09-03
Last Update Date:2017-06-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0110005008363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant