Provider Demographics
NPI:1336700798
Name:HATCHER, GWENDA K (NP)
Entity Type:Individual
Prefix:MS
First Name:GWENDA
Middle Name:K
Last Name:HATCHER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7525 E BROADWAY RD STE 2
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85208-1154
Mailing Address - Country:US
Mailing Address - Phone:480-981-9800
Mailing Address - Fax:480-930-4615
Practice Address - Street 1:7525 E BROADWAY RD STE 2
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85208-1154
Practice Address - Country:US
Practice Address - Phone:480-981-9800
Practice Address - Fax:480-930-4615
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ228154363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner