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Individual
LAURA HATCH
Active
Individual
LAURA HATCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1177
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1177
STATE LICENSE NUMBER
NE
01
—
38944
BCBS
—
05
—
47077294513
—
NE
Enumeration date
05/25/2006
Last updated
06/20/2012
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