Provider Demographics
NPI:1336277300
Name:HATCH, ANDREA A (RN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:A
Last Name:HATCH
Suffix:
Gender:F
Credentials:RN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 CHEATHAM ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:TN
Mailing Address - Zip Code:37172-2828
Mailing Address - Country:US
Mailing Address - Phone:615-463-6200
Mailing Address - Fax:615-463-6202
Practice Address - Street 1:713 CHEATHAM ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:TN
Practice Address - Zip Code:37172-2828
Practice Address - Country:US
Practice Address - Phone:615-463-6200
Practice Address - Fax:615-463-6202
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
TN20494363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health