Individual
LAURA HATCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3907 6TH AVE, KEARNEY, NE 68845-3392
(308) 865-2767
(308) 865-2765
Mailing address
607 W 9TH ST, KEARNEY, NE 68845-7347
(402) 366-2185
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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